"Time equals brain – we want to move in quickly and terminatethat process [seizures] before it really gets out of control."
– Stephan Mayer, MD, FCCM
Systemic complications can occur in every stage of the evolution from SE to SRSE.4
Systemic complications associated with SRSE are complex1 and primarily relate to2,5,6:
Complications of prolonged ICU care can include2,4:
Other infectious complications(e.g., catheter-associated urinary tract infections, sepsis, blood stream infections, pseudomembranous colitis)
ICU-acquired weakness(e.g., critical illness myopathy, critical illness neuropathy)
Further complications may be avoided by limiting
the amount of time the patient is immobilized
and exposed to the ICU environment.4
A diverse team of medical professionals plays a critical role in the treatment and management of SRSE. It is
critical that patients have access to an interdisciplinary team of experts to consult and care for SRSE.
Status epilepticus patients arriving at the hospital are likely admitted to the ER first and evaluated and treated by ER physicians. Upon further evaluation of symptoms and/or lack of first-line treatment efficacy, other specialized medical personnel become involved in the diagnosis, treatment, and management of these patients.
With specialized training in the study and treatment of disorders of the nervous system, neurologists are key players in making treatment decisions, including the use of intravenous general anesthetics and weaning, for SRSE patients in the intensive care unit (ICU). Often, the neurologist is called in as a consult.
Critical care and neurocritical care physicians (intensivists) are responsible for managing the broad care of a SRSE patient in the ICU. The intensivist and the ICU medical team (which includes, but is not limited to, physicians, nurses, EEG technicians, social workers, rehabilitation support, pharmacists, etc) provide close observation and monitoring of the SRSE patient’s vital signs and offer support for the patient’s holistic care.
Also known as electroneurodiagnostic technologists, these professionals are trained to operate and interpret electroencephalographs (EEGs), which are crucial for the diagnosis and monitoring of SRSE. Read more about the important role of continuous EEGs (cEEG).
Nurses play an interdisciplinary role in SRSE patient care. They are important for coordinating diagnostic testing and providing medical attention to patients with SRSE. Nurses may offer vitals support, assisting with cEEGs and other diagnostic devices, administration of drugs, monitoring wean attempts, and communicating with the patient’s family members.
With advanced knowledge of and expertise in various pharmacologic medications and drug interactions, critical care pharmacists assist the medical team in the evaluation of clinical data and decision-making about pharmacological interventions. They play a vital role in proper administration of drugs and reducing medication errors.
How familiar are you with managing SRSE? See how your answers compare to key thought leaders.