Seizure patients have a better chance of surviving without brain damage when paramedics inject them directly with medication, rather than starting an IV on the way to the emergency room, according to a nationwide study involving San Francisco paramedics and hospitals.
“It’s going to make it more likely the seizure will stop by the time they get to the hospital,” said Dr. Claude Hemphill, a neurologist at San Francisco General Hospital. “There’s really no reason for agencies not to switch to this method right away.”
Hemphill led The City’s portion of the clinical trial, which was funded by the National Institutes of Health and also involved 16 other cities.
Seizures can lead to brain damage or death, so paramedics are trained to start an intravenous line on a seizing patient and use it to administer anti-seizure drugs during the drive to the hospital. The study compared the effectiveness of the IV with an auto-injector, a pre-loaded syringe similar to the EpiPen that many allergy patients carry.
The results of the trial, which were published this week in the New England Journal of Medicine, found that 73 percent of patients in the group receiving the injections were seizure-free when they got to the hospital, compared to 63 percent of patients who received their medicine through an IV. The patients who got the direct injection were also less likely to require hospitalization.
Judy Klofstad, a paramedic with the San Francisco Fire Department, said the injection was much quicker, easier and safer for emergency responders.
“You put it in contact with the thigh, then you push a button on the end like clicking a pen,” she said. “It has the potential to change a lot of things. It’s very difficult to start an IV on a moving patient.”
Tiffany Manning, who has epilepsy, said the study would have the potential to change things for patients as well.
“For people who are in a seizure, with the risk of suffering brain damage, this will help,” said Manning, 30, a volunteer with the Epilepsy Foundation of Northern California. “There are so many people with epilepsy who need it.”
A safer method?
San Francisco doctors, paramedics and patients took part in a massive study to demonstrate a safer and faster way to help patients having seizures.
121 patients in San Francisco
55,000 deaths each year associated with prolonged seizures
Source: San Francisco General Hospital