70 likes | 244 Views
Clinical Guidelines in Acute Seizure Management. William C. Dalsey, MD, FACEP, MBA Department of Emergency Medicine Robert Wood Johnson University Hospital New Jersey sparkledmd@aol.com 215-654-1190. How Do You Begin to Create a Clinical Guideline for Seizures?. Selecting the Topic
E N D
Clinical Guidelines in Acute Seizure Management William C. Dalsey, MD, FACEP, MBA Department of Emergency Medicine Robert Wood Johnson University Hospital New Jersey sparkledmd@aol.com 215-654-1190
How Do You Begin to Create a Clinical Guideline for Seizures? • Selecting the Topic • Selecting Members of the Committee • Process for Evaluating the Literature • Process to Create Clinical Guideline
Critical Questions • How do you evaluate and treat a patient with a seizure? • Complicating Factors: Status Epilepticus? Hypoglycemia, Febrile Seizures, Alcohol Withdrawal, Trauma, Eclampsia
What is best? • Efficacy of Treatment? • Safety? • Complications? Side Effects? • Route of Administration? • Costs? • Society/Ethics?
Are There Existing Practice Guidelines? • www.guidelines.gov • AMA Clinical Guidelines Clearinghouse • Cochrane Library
Asking the “Right” Questions • The need to be specific • Identification of inclusion/exclusion criteria • Searching the Literature • Metanalysis and Nonrandomized Trials