Abstracts

Rationale: Parents of children with epilepsy acquire knowledge in first aid management of seizures and administer emergent benzodiazepine medications for prolonged or clustered seizures. The aim of this study is to identify knowledge gaps regarding home management for acute seizures among parents of children with epilepsy. Methods: A telephone survey of parents of children with epilepsy utilizing the nursing telephone triage line at the Mayo Clinic Pediatric Epilepsy Clinic was performed. A nurse administered the telephone survey over ten working days. The survey included questions regarding access of home seizure rescue medications, parental knowledge and attitude regarding the child's seizure rescue medications, and effectiveness of home management of acute seizures. Results: Eighteen parents (94% mothers) of children with epilepsy were surveyed during the study period. Parents reported a history of prolonged (greater than five minutes) seizures in 10 (56%) children, 3 or more seizures in an hour in 15 (83%), and seizure free control without need for acute seizure rescue medication in 1. Among the 17 with ongoing seizures, all had an active rescue plan. Diazepam Intensol and rectal diazepam (Diastat) were the two most commonly used home seizure rescue medication. Parents reported they would administer rescue medication at five minutes in 7 (41%), less than 5 minutes in 4 (24%) and greater than 5 minutes in 6 (35%). Seven out of 12 parents (58%) who have Diazepam Intensol and three of seven (43%) who had Diastat at home verbalized correct administration (for Intensol - buccal administration with child lying on their side, for Diastat, Rectal administration with child lying on side using a 3 count process). Only 5/12 (42%) families with Diazepam Intensol knew that it expired 90 days after opening the bottle. Respiratory depression was identified by 10 (59%) parents as a potential side effect of benzodiazepines. All but one parent surveyed felt having the rescue medication available to them was beneficial because it kept them from calling an ambulance or going to the emergency department, and made them feel they had some control over the treatment of seizures. Eleven of 17 parents (65%) had used emergent benzodiazepine at least once during the past 12 months. Conclusions: While most families have an emergency seizure rescue plan in place, knowledge gaps exist. Nearly half of responders provided could not correctly verbalize how to administer rescue medication and nearly half were not aware of respiratory depression as a side effect. A standardized training program by nursing, with regular reviews at clinic visits is needed to improve parental proficiency in the home management of acute seizures.