Patients who have seizures may receive faster and more effective treatment because of a collaboration between the UA and the National Institutes of Health.
Seventeen emergency medical centers and 33 fire departments, including the Arizona Emergency Medicine Research Center and the Glendale Fire Department, participated in the study that aimed to stop prolonged seizures lasting more than a few minutes.
The Rapid Anticonvulsant Medications Prior to Arrival Trial study, sponsored by the National Institutes of Health, determined whether an intramuscular injection, which quickly delivers anticonvulsant medicine into a patient’s thigh muscle, is as safe and effective as giving medicine directly into a vein with an IV, said Michael Young, a Glendale Fire Department paramedic.
The study compared two medicines, Midazolam and Lorazepam, which are proven to be effective in controlling seizures. Midazolam was absorbed more rapidly in the muscles than Lorazepam, which must be given by IV, said Kurt Denninghoff, the study’s principal investigator and a professor of emergency medicine.
In the study, one group was treated with the IV and the second group was treated with the intramuscular injection, said Bruce Barnhart, a senior research nurse coordinator.
Paramedics carried out the experiment, and compared how well delivery of each medicine stopped patients’ seizures by the time an ambulance arrived at the emergency department, Young said. Every patient was given either an intramuscular injection or was hooked to an IV.
“If seizures continued, then a rescue medication was given,” Denninghoff said.
Administering an IV to a patient on the field can be very difficult for a first responder, but treating patients with intramuscular injection has its advantages over other treatments, Young added.
The study later found that patients who were treated with Midazolam were seizure-free upon arrival to the hospital, Barnhart said, and they were less likely to need hospitalization than patients who received the Lorazepam treatment through an IV.
Midazolam injected into the muscle showed that the auto-injector in the leg was faster and more effective at stopping seizures than other methods, Young said.
