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

ObjectivePatients 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.MethodsThis 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.ResultsForty-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.ConclusionsIn 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).