(Title)
Audit of compliance of paediatric seizure protocol in a tertiary care hospital
(Reason for choice of audit)
Seizures are a commonest neurological problem, and its neurological outcome is a concern to every
pediatrician in developing countries. Status epilepticus (SE) is a continuous or rapid sequential seizure
activity for 30 minutes or more – is a medical emergency with a high mortality rate in children. The
incidence of SE is 18–23 per 100,000 children per year. There is significant morbidity (28 34%) and ‐
mortality (7-22%) with SE despite advancement in treatment protocols in the last decade. It is
documented that if convulsion persisted beyond 10 minutes, it leads to irreparable brain damage and
difficulty in controlling the seizure. Childhood survivors of SE may develop long-term consequences such
as developmental delay, cognitive impairment, and recurrent seizure.
To find out extent of adherence of paediatric protocol in managing children with seizures. To find out
whether the interventions done to the patient during seizure activity are documented in the case
records.
(Criteria)
Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure.
This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or brain concussion. But
when a child has 2 or more seizures with no known cause, this is diagnosed as epilepsy.
Epilepsy is a disorder of the brain which is explained as an enduring predisposition to generate seizures
and by its neurobiological, cognitive, psychological, and social consequences.
A febrile seizure is a convulsion in a child that is caused by a fever. The fever may occur from an
infection. Febrile seizures can occur in young, healthy children who have normal development and not
had any neurological symptoms before.
A seizure which lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period,
without returning to normal level of consciousness between episodes is called status epilepticus.
(Standards set and rationale)
Clinical data are in standard case sheets. Different sets on case sheets when the patient comes to
emergency department and shifted to PICU and to ward. Definition of standard protocols for treatment
and interventions.
