Intubation in children presenting with seizures to a pediatric emergency department in a safety net hospital.

OBJECTIVE

Patients seen for uncontrolled seizures in a Pediatric Emergency Department (ED) often undergo tracheal intubation (TI). We looked at factors associated with TI in children in a safety net hospital.

METHODS

This was a single-center retrospective case series. Fifty-six patients who had ongoing seizures at the time of arrival to the pediatric ED, between ages 0-21 years, were analyzed for demographics, seizure duration, seizure types, indications for TI, antiseizure medication on discharge, and neurological sequelae.

RESULTS

Forty-six percent of patients (26/56) underwent TI. The most common type of seizures in the intubated group was a complex febrile seizure (27%). Forty-two percent were intubated for airway protection and 46% were intubated for respiratory failure.

CONCLUSIONS

In all patients presenting to a Pediatric ED with uncontrolled seizures, those undergoing TI most often had complex febrile convulsions, seizures longer in duration (p = 0.036), and seizures needing poly-drug therapy for seizure control (p < 0.001).