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首页> 外文期刊>Prehospital emergency care >Midazolam and diazepam for pediatric seizures in the prehospital setting.
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Midazolam and diazepam for pediatric seizures in the prehospital setting.

机译：咪达唑仑和地西epa在院前环境中用于小儿惊厥。

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Objective. The objective of this study was to compare the efficacy and adverse events associated with the use of diazepam and midazolam for the treatment of pediatric seizures in the prehospital setting. Methods. This was a retrospective cohort study of all patients younger than 18 years treated for a seizure with a benzodiazepine by emergency medical services in Multnomah County, Oregon, from 1998 to 2001. The emergency medical services system consists of a single private advanced life support transporting ambulance service with fire department first responders that are all advanced life support capable. The benzodiazepine used changed from diazepam to midazolam at the midpoint of this period. The primary outcomes were termination of the seizure by arrival to the emergency department (ED), recurrence of seizure while in the ED, or the requirement for active airway interventions including intubation. The two cohorts were also compared for demographics, past history of seizures, long-term use of seizuremedications, response times, route of administration, use of second doses of benzodiazepines, and final disposition. Results. Forty-five patients were treated with diazepam, and 48 were treated with midazolam. The two cohorts were comparable except the diazepam cohort had a significantly increased proportion of patients with previous afebrile seizures (53% vs. 25%; p = 0.005). The midazolam cohort had an increased use of nonintravenous route for initial dosing (65% vs. 42%; p = 0.02). The two cohorts were equivalent in rates of termination of seizures before to ED arrival, recurrence of seizures in the ED, requiring airway support or a second dose of benzodiazepine, and admission to the hospital. Conclusions. Diazepam and midazolam appear to be equivalent in treating seizures and causing adverse events. Paramedics appear to be administering midazolam intramuscularly more often than they use diazepam rectally.
机译：目的。这项研究的目的是比较在院前环境中使用地西m和咪达唑仑治疗小儿惊厥的疗效和不良事件。方法。这是一项回顾性队列研究，研究对象是1998年至2001年在俄勒冈州摩特诺玛县接受急诊医疗服务治疗的所有未满18岁的苯二氮卓类癫痫发作的所有患者。紧急医疗服务系统由一个私人高级生命支持运送救护车组成具备消防部门第一反应人员的服务，这些人员均具有先进的生命支持能力。在此期间的中点，所用的苯二氮卓类药物从地西epa变为咪达唑仑。主要结果是到达急诊室（ED）终止癫痫发作，在急诊室再次发作或需要进行积极的气道干预，包括插管。还比较了这两个队列的人口统计学，过去的癫痫病史，长期使用癫痫药，反应时间，给药途径，使用第二剂苯二氮卓类药物和最终处置情况。结果。 45例患者接受地西epa治疗，48例接受咪达唑仑治疗。除地西epa组以前有高热惊厥的患者比例显着增加外，这两个组是可比较的（53％对25％; p = 0.005）。咪达唑仑组增加了非静脉途径用于初始给药的比例（65％比42％; p = 0.02）。这两个队列在ED到达之前癫痫发作的终止，ED中癫痫发作的复发，需要气道支持或第二剂苯二氮卓的入院率相同。结论。地西p和咪达唑仑似乎在治疗癫痫发作和引起不良事件方面是等效的。护理人员似乎在肌内给药咪达唑仑的频率要比他们在直肠上使用地西epa的频率高。

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