Incidenceof out-of-hospital adult nontraumatic cardiac arrest presenting as a convulsion
Details
Serval ID
serval:BIB_288EA734EA8E
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Incidenceof out-of-hospital adult nontraumatic cardiac arrest presenting as a convulsion
Title of the conference
2011 NAEMSP Scientific Assembly, National Association of EMS Physicians Scientific Assembly
Address
Bonita Springs, Florida, United-States, January 13-15, 2011
ISBN
1545-0066
ISSN-L
1090-3127
Publication state
Published
Issued date
2011
Volume
15
Series
Prehospital Emergency Care
Pages
128
Language
english
Abstract
Introduction: The majority of convulsions are due to an epileptic seizure or a convulsive syncope. The incidence of out-of-hospital cardiac arrest (OH-CA) presenting as a convulsion is unknown.
Objective: This study aimed to measure the incidence of adult nontraumatic OH-CA presenting as a convulsion, a rate that has not been published so far, to the best of our knowledge.
Methods: We prospectively collected all incoming calls with an out-of-hospital nontraumatic seizure as the chief complaint in patients >18 years old during a 24-month period. Among these calls, we collected cases identified as OH-CA by paramedics.
Results: During the 24-month period, the emergency medical services (EMS) dispatch center received 561 calls for an out-of-hospital
nontraumatic convulsion in an adult. Twelve cases were ultimately classified as CA. In this group, one bystander spontaneously reported
that the patient was known for epilepsy. The incidence of OH-CA presenting as convulsions was therefore 2.1% of all calls for convulsion.
Over the same period, the EMS dispatch center received 1,035 calls related to an adult nontraumatic OH-CA. Therefore, the rate of OH-CA
presenting as a convulsion represented 1.2% of all adult nontraumatic OH-CA.
Conclusion:L Only 12 cases out of the 531 calls for nontraumatic adult convulsions were confirmed OHCA (2.1%). Nevertheless, this unusual presentation of OH-CA must be recognized by dispatchers, even when a patient is reported by bystander as a known epileptic. Dispatchers
should keep bystanders on the line or call them back before paramedics' arrival, and have them confirm the progressive return of a normal pat-
tern of breathing and state of consciousness; if not, they should encourage the bystander to initiate CPR when necessary. An intervention
should be implemented to improve the detection by dispatchers of OH-CA presenting as convulsion by the development of a specific interview and directed observation. For dispatchers, a past medical history of epilepsy should not be regarded as sufficient information to rule out OH-CA. It is mandatory that known epileptic patients should be monitored in the same way as nonepileptic patients.
Objective: This study aimed to measure the incidence of adult nontraumatic OH-CA presenting as a convulsion, a rate that has not been published so far, to the best of our knowledge.
Methods: We prospectively collected all incoming calls with an out-of-hospital nontraumatic seizure as the chief complaint in patients >18 years old during a 24-month period. Among these calls, we collected cases identified as OH-CA by paramedics.
Results: During the 24-month period, the emergency medical services (EMS) dispatch center received 561 calls for an out-of-hospital
nontraumatic convulsion in an adult. Twelve cases were ultimately classified as CA. In this group, one bystander spontaneously reported
that the patient was known for epilepsy. The incidence of OH-CA presenting as convulsions was therefore 2.1% of all calls for convulsion.
Over the same period, the EMS dispatch center received 1,035 calls related to an adult nontraumatic OH-CA. Therefore, the rate of OH-CA
presenting as a convulsion represented 1.2% of all adult nontraumatic OH-CA.
Conclusion:L Only 12 cases out of the 531 calls for nontraumatic adult convulsions were confirmed OHCA (2.1%). Nevertheless, this unusual presentation of OH-CA must be recognized by dispatchers, even when a patient is reported by bystander as a known epileptic. Dispatchers
should keep bystanders on the line or call them back before paramedics' arrival, and have them confirm the progressive return of a normal pat-
tern of breathing and state of consciousness; if not, they should encourage the bystander to initiate CPR when necessary. An intervention
should be implemented to improve the detection by dispatchers of OH-CA presenting as convulsion by the development of a specific interview and directed observation. For dispatchers, a past medical history of epilepsy should not be regarded as sufficient information to rule out OH-CA. It is mandatory that known epileptic patients should be monitored in the same way as nonepileptic patients.
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22/05/2013 13:31
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20/08/2019 13:08
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