医护人员强直阵挛性癫痫发作的急救管理：意大利癫痫联盟普利亚分会的调查。

First-aid management of tonic-clonic seizures among healthcare personnel: A survey by the Apulian section of the Italian League Against Epilepsy.

机构信息

Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy.

出版信息

Epilepsy Behav. 2018 Mar;80:321-325. doi: 10.1016/j.yebeh.2017.11.017. Epub 2018 Feb 3.

DOI:10.1016/j.yebeh.2017.11.017

PMID:29402633

Abstract

INTRODUCTION

To evaluate the knowledge of healthcare workers about first-aid measures to be performed during and after a tonic-clonic seizure.

METHODS

One hundred and fifty-four healthcare workers (86 physicians) working at 8 tertiary hospitals in the Apulia region, Italy, responded to a questionnaire comprising of 28 questions based on available Italian and international recommendations about what to do during a tonic-clonic seizure.

RESULTS

One hundred and fifty-four healthcare workers completed and returned surveys with a response rate of 96.25%. There were 55 nurses (35.7%), 86 physicians (55.8%), and 13 healthcare workers with different roles (Electroencephalograph technicians, psychologists, social workers). Among physicians, there were 7 cardiologists, 3 surgeons, 12 infectious-disease specialists, 11 internal medicine specialists, 2 psychiatrists, 2 gynecologists, 27 specialists working in the emergency department, and 22 physicians with different specializations. Nearly 90% of the respondents identified head protection as important first aid, while 100% responded to not keep the legs elevated. To avoid tongue bite, both physicians and other healthcare workers would put something in the mouth (54.0%), like a Guedel cannula (71.0%) fingers (29.5%). Grabbing arms and legs, trying to stop the seizure, would be potentially performed by 11.6% of our sample. Physicians would administer a benzodiazepine during the seizure (65.7%) and during the postictal phase (29.2%), even if the patient is known to have epilepsy (23.7%), and in this case, 11.3% of respondents would administer the usual antiepileptic medications. More than half of respondents would call the emergency telephone number, because of necessary hospitalization in case of tonic-clonic seizure, even if it is experienced by a patient known to have epilepsy.

CONCLUSION

Our survey suggests the need for epilepsy educational programs on first-aid management of seizures among healthcare workers.

摘要

简介

评估医护人员对强直-阵挛性发作期间和之后进行急救措施的了解程度。

方法

意大利普利亚地区 8 家三级医院的 154 名医护人员（86 名医生）回答了一份包含 28 个问题的问卷，这些问题基于现有的意大利和国际建议，内容是关于在强直-阵挛性发作期间应该做什么。

结果

154 名医护人员完成并返回了调查，回复率为 96.25%。其中有 55 名护士（35.7%），86 名医生（55.8%）和 13 名具有不同角色的医护人员（脑电图技术员、心理学家、社会工作者）。在医生中，有 7 名心脏病专家、3 名外科医生、12 名传染病专家、11 名内科专家、2 名精神科医生、2 名妇科医生、27 名急症专科医生和 22 名具有不同专业的医生。近 90%的受访者认为头部保护是重要的急救措施，而 100%的人则表示不会抬高腿部。为了避免咬到舌头，医生和其他医护人员会将东西放入口中（54.0%），如格德尔氏导管（71.0%）或手指（29.5%）。我们的样本中，有 11.6%的人会抓住手臂和腿部，试图阻止发作。如果患者已知患有癫痫，医生会在发作期间（65.7%）和发作后（29.2%）给予苯二氮䓬，即使患者已知患有癫痫，在这种情况下，11.3%的受访者会给予常规的抗癫痫药物。超过一半的受访者会拨打急救电话，因为如果发生强直-阵挛性发作，需要住院治疗，即使是已知患有癫痫的患者。