RAMPART Study

[Grady_emt]

Anyone else's agency enrolled in the Rapid Anticonvulsant Medication Prior to Arrival Trial? I just learned today that we will be participating in the study. Haven't had the full inservice yet, it was just mentioned in a different meeting.

My understanding that on any siezing pt, we will have a seperate protocol for the study. We will administer either 10mg Versed IM, or 4 of Ativan IV. The study is evaluating the effectiveness of Versed vs Ativan, and could provide the justification to stock Ativan on many more EMS services if it is shown to be more effective at reducing the sz.


http://www.nett.umich.edu/nett/_rampart

 

[VentMedic]

For those in the SF Bay area, Stanford and UC San Francisco will be participating. This should include Santa Clara, San Mateo and San Francisco.

Here's a little more information with a list of centers included in the study.

http://pub.ucsf.edu/today/cache/feature/200809032.html

 

[reaper]

The one I read about was Ativan IV vs Versed IN. I do not know if this is the same study.

I would take the Versed for a seizure. It controls the entire seizure, not just the muscular part.

 

[Flight-LP]

Anyone else's agency enrolled in the Rapid Anticonvulsant Medication Prior to Arrival Trial? I just learned today that we will be participating in the study. Haven't had the full inservice yet, it was just mentioned in a different meeting.

My understanding that on any siezing pt, we will have a seperate protocol for the study. We will administer either 10mg Versed IM, or 4 of Ativan IV. The study is evaluating the effectiveness of Versed vs Ativan, and could provide the justification to stock Ativan on many more EMS services if it is shown to be more effective at reducing the sz.


http://www.nett.umich.edu/nett/_rampart

Ativan is a great drug and already well tested and utilized in the pre-hospital environment. The main logistic issue is the temperature requirements of Ativan. It needs to be refridgerated, hence why most who want it don't have it.

 

[Grady_emt]

Ativan is a great drug and already well tested and utilized in the pre-hospital environment. The main logistic issue is the temperature requirements of Ativan. It needs to be refridgerated, hence why most who want it don't have it.

My understanding is that they are trying to justify the logistical aspect of it for more agencies. Like I said, I havent had our inservice on the study yet, it was just mentioned in a CQI meeting. We will be participating as a pre-hospital EMS agency, not hospital wide.

 

[artman17847]

we currently carry Ativan in our boxes. Used it today on a siezure pt, it is very effective.

 

[Juxel]

There's a lot of parts of this message, first a question: For those of you who carry both versed and ativan, what do your protocols say about when to use one or the other? Is it entirely medic discretion or do you have guidelines for the use of one or the other?

There was a study done comparing the use of IN versed and PR diazepam in the pediatric population. They found that IN versed worked much better (Fast, longer lasting with less complication) than PR diazepam. My service has IN versed and in my experience it has worked wonders. Most adult seizures you should be able to get an IV, but the pediatrics can be tricky.

On a sidenote, I'm not in favor of carrying Ativan in the prehospital setting despite the fact that my service does and it is my drug of choice in the ED.

Holsti, et. al. Prehospital intranasal midazolam for the treatment of pediatric seizures. Pediatr Emerg Care. 2007 Mar;23(3):148-53.

 

[reaper]

Ativan is a great drug and already well tested and utilized in the pre-hospital environment. The main logistic issue is the temperature requirements of Ativan. It needs to be refrigerated, hence why most who want it don't have it.

We carry Ativan on our trucks. Per the manufacture, it is like Sucs. It will stay good for up to two weeks, out of the fridge. We date it as soon as it comes out and it is rotated out before the date.

Ativan is a good for seizures, but I still prefer Versed over it.

 

[Speedylifsavr]

We use Ativan 2mg IV for seizures . We carry Versed but it is only used for sedation prior to cardioversion and intubation .