Australasian emergency care · 2026
Multidisciplinary perspectives on managing functional/dissociative seizures in the emergency department: A survey of medical, nursing, and allied health clinicians.
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Higson Lana, Mitra Biswadev, Hope Rebecca, O'Brien Terence J, Winton-Brown Toby
Аннотация
BACKGROUND: Patients with functional/dissociative seizures (FDS) commonly present to emergency departments (ED), but the practices of the multidisciplinary emergency care workforce have not been described.
METHODS: A cross-sectional survey was administered to medical, nursing, and allied health clinicians at two EDs of an Australian metropolitan tertiary health service, between August-December 2025. Closed items were analysed descriptively; open-ended responses were analysed using conventional qualitative content analysis.
RESULTS: Of 930 clinicians invited, 101 participated (55 medical, 36 nursing, 10 allied health); 93 (92%) had witnessed a FDS in their ED work, yet 88 (87%) reported little to no training and 73 (72%) had little to no understanding of FDS. Management approaches employed included reassurance (49%), a safe low-stimulus environment (28%) and watchful waiting (29%), with deliberately conservative pharmacology amongst more experienced medical staff. Challenges included treatment disagreement (30%), patient or family expectations (30%) and stigma (21%). Three priorities emerged: a departmental pathway (32%), patient-specific management plans (18%), and multidisciplinary training (18%).
CONCLUSIONS: Multidisciplinary emergency care clinicians manage FDS based on clinical experience rather than formal training. The three priorities identified by ED clinicians for practice development require prospective evaluation.
METHODS: A cross-sectional survey was administered to medical, nursing, and allied health clinicians at two EDs of an Australian metropolitan tertiary health service, between August-December 2025. Closed items were analysed descriptively; open-ended responses were analysed using conventional qualitative content analysis.
RESULTS: Of 930 clinicians invited, 101 participated (55 medical, 36 nursing, 10 allied health); 93 (92%) had witnessed a FDS in their ED work, yet 88 (87%) reported little to no training and 73 (72%) had little to no understanding of FDS. Management approaches employed included reassurance (49%), a safe low-stimulus environment (28%) and watchful waiting (29%), with deliberately conservative pharmacology amongst more experienced medical staff. Challenges included treatment disagreement (30%), patient or family expectations (30%) and stigma (21%). Three priorities emerged: a departmental pathway (32%), patient-specific management plans (18%), and multidisciplinary training (18%).
CONCLUSIONS: Multidisciplinary emergency care clinicians manage FDS based on clinical experience rather than formal training. The three priorities identified by ED clinicians for practice development require prospective evaluation.