Abstract：
To describe acute seizure treatment for the long-term care setting, emphasizing rescue (acute abortive) medications for on-site management of acute unexpected seizures and seizure clusters.
Narrative review.
People with seizures in long-term care, including group residences.
PubMed was searched using keywords that pertained to rescue medications, seizure emergencies/epilepsy, seizure action plans, and long-term care.
Seizure disorder, including epilepsy, is prevalent in long-term care residences, and rescue medications can be used for on-site treatment. Diazepam rectal gel, intranasal midazolam, and diazepam nasal spray are US Food and Drug Administration (FDA)-approved seizure-cluster rescue medications, and intravenous diazepam and lorazepam are approved for status epilepticus. Benzodiazepines differ by formulation, route of administration, absorption, and metabolism. Intranasal formulations are easy and ideal for public use and when rectal treatment is challenging (eg, wheelchair). Intranasal, intrabuccal, and rectal formulations do not require specialized training to administer and are easier for staff at all levels of training compared with intravenous treatment. Off-label rescue medications may have anecdotal support; however, potential disadvantages include variable absorption and onset of action as well as potential risks to patients and caregivers or care partners. Delivery of intravenous-administered rescue medications is delayed by the time needed to set up and deliver the medication and is subject to dosing errors. Seizure action plans that include management of acute seizures can optimize the quality and timing of treatment, which may reduce emergency service needs and prevent progression to status epilepticus.
Seizure disorder is prevalent across all ages but is increased in older adults and in those with intellectual and developmental disabilities. Prompt intervention may reduce negative outcomes associated with acute unexpected seizures and seizure clusters. Seizure action plans that include acute seizures can improve the treatment response by detailing the necessary information for staff to provide immediate treatment.
Narrative review.
People with seizures in long-term care, including group residences.
PubMed was searched using keywords that pertained to rescue medications, seizure emergencies/epilepsy, seizure action plans, and long-term care.
Seizure disorder, including epilepsy, is prevalent in long-term care residences, and rescue medications can be used for on-site treatment. Diazepam rectal gel, intranasal midazolam, and diazepam nasal spray are US Food and Drug Administration (FDA)-approved seizure-cluster rescue medications, and intravenous diazepam and lorazepam are approved for status epilepticus. Benzodiazepines differ by formulation, route of administration, absorption, and metabolism. Intranasal formulations are easy and ideal for public use and when rectal treatment is challenging (eg, wheelchair). Intranasal, intrabuccal, and rectal formulations do not require specialized training to administer and are easier for staff at all levels of training compared with intravenous treatment. Off-label rescue medications may have anecdotal support; however, potential disadvantages include variable absorption and onset of action as well as potential risks to patients and caregivers or care partners. Delivery of intravenous-administered rescue medications is delayed by the time needed to set up and deliver the medication and is subject to dosing errors. Seizure action plans that include management of acute seizures can optimize the quality and timing of treatment, which may reduce emergency service needs and prevent progression to status epilepticus.
Seizure disorder is prevalent across all ages but is increased in older adults and in those with intellectual and developmental disabilities. Prompt intervention may reduce negative outcomes associated with acute unexpected seizures and seizure clusters. Seizure action plans that include acute seizures can improve the treatment response by detailing the necessary information for staff to provide immediate treatment.
摘要：
目的：描述长期护理机构的急性癫痫发作治疗，强调抢救（急性流产）药物，用于急性意外癫痫发作和癫痫发作集群的现场管理。
方法：叙事回顾。
方法：长期护理癫痫患者，包括集团住宅。
方法：使用与抢救药物有关的关键字搜索PubMed，癫痫发作紧急情况/癫痫，缉获行动计划,和长期护理。
结果：癫痫发作障碍，包括癫痫,在长期护理住宅中普遍存在，救援药物可用于现场治疗。地西泮直肠凝胶，鼻内咪达唑仑，和地西泮鼻喷雾剂是美国食品和药物管理局（FDA）批准的癫痫发作-集群救援药物，静脉注射地西泮和劳拉西泮被批准用于治疗癫痫持续状态.苯二氮卓类药物的配方不同，给药途径,吸收，和新陈代谢。鼻内制剂是方便和理想的公共使用，当直肠治疗是具有挑战性的（例如，轮椅)。鼻内,颊内,直肠制剂不需要专门的管理培训，与静脉治疗相比，各级培训的工作人员更容易。标示外的救援药物可能有轶事支持；然而，潜在的缺点包括可变的吸收和起效以及对患者和护理人员/护理伙伴的潜在风险.静脉内施用的救护药物的递送由于设置和递送药物所需的时间而被延迟,并且受到给药错误的影响。包括急性癫痫发作管理在内的癫痫发作行动计划可以优化治疗质量和时机，这可能会减少紧急服务需求并防止进展为癫痫持续状态。
结论：癫痫发作障碍在所有年龄段普遍存在，但在老年人和智力和发育障碍患者中有所增加。及时的干预可能会减少与急性意外癫痫发作和癫痫发作集群相关的负面结果。包括急性癫痫发作的癫痫发作行动计划可以通过详细说明工作人员提供即时治疗的必要信息来改善治疗反应。
方法：叙事回顾。
方法：长期护理癫痫患者，包括集团住宅。
方法：使用与抢救药物有关的关键字搜索PubMed，癫痫发作紧急情况/癫痫，缉获行动计划,和长期护理。
结果：癫痫发作障碍，包括癫痫,在长期护理住宅中普遍存在，救援药物可用于现场治疗。地西泮直肠凝胶，鼻内咪达唑仑，和地西泮鼻喷雾剂是美国食品和药物管理局（FDA）批准的癫痫发作-集群救援药物，静脉注射地西泮和劳拉西泮被批准用于治疗癫痫持续状态.苯二氮卓类药物的配方不同，给药途径,吸收，和新陈代谢。鼻内制剂是方便和理想的公共使用，当直肠治疗是具有挑战性的（例如，轮椅)。鼻内,颊内,直肠制剂不需要专门的管理培训，与静脉治疗相比，各级培训的工作人员更容易。标示外的救援药物可能有轶事支持；然而，潜在的缺点包括可变的吸收和起效以及对患者和护理人员/护理伙伴的潜在风险.静脉内施用的救护药物的递送由于设置和递送药物所需的时间而被延迟,并且受到给药错误的影响。包括急性癫痫发作管理在内的癫痫发作行动计划可以优化治疗质量和时机，这可能会减少紧急服务需求并防止进展为癫痫持续状态。
结论：癫痫发作障碍在所有年龄段普遍存在，但在老年人和智力和发育障碍患者中有所增加。及时的干预可能会减少与急性意外癫痫发作和癫痫发作集群相关的负面结果。包括急性癫痫发作的癫痫发作行动计划可以通过详细说明工作人员提供即时治疗的必要信息来改善治疗反应。
