병원 전 단계에서 항경련제 투여 가능성에 대한 고찰

초록

Purpose: The aim of this study was to evaluate the reliabilityof the chief complaint addressing seizure in 119 runsheetsand to estimate the frequency of recommendedadministration of prehospital anti-convulsants. Methods: A retrospective medical review of the period from1 January, 2007 to 1 December, 2012 at one universityhospital was conducted. Patients who were transported by119 ambulance and whose chief complaint addressingseizure were enrolled. Medical records were independentlyreviewed by two emergency physicians. The reliability wasanalyzed according to the level of prehospital providers. prehospital providers. The operational definition of prehospitalstatus epilepticus was cases with prolonged (lastingfive minutes or more) or repetitive generalized convulsiveseizures and seizure witnessed by 119 providers or persistentseizure at the time of arrival at the hospital. Results: Among 239 medical records, 188(78.7%) caseswith seizure were identified. The reliability was increasedwhen level I emergency medical technicians were staffed(90.6 % vs 74.3 %). Psychiatric disorders(4.6%) and hyperventilationsyndrome(3.8%) were frequently confused withseizure. Prehospital anti-convulsants were recommendedin 15 cases(6.3%). Conclusion: Chief complaints addressing seizure by 119prehospital providers were reliable. Not only rarity of prehospitalstatus epilepticus but also other medical and legalbarriers should be considered in regard to the possibility ofprehospital anti-convulsant administration.

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