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Clackamas Fire District helps with injection study

Participant firefighters honored at event on Monday

Injecting an anti-convulsant drug into muscle is faster and possibly more effectively stops epileptic seizures than delivering a drug intravenously, according to a study conducted at Clackamas Fire District No. 1 and published in a recent issue of the New England Journal of Medicine.

At the Clackamas Fire District Board meeting May 21 several people were honored, including the fire district as a whole, for participation in the emergency medical study.

The study was conducted over three years at Oregon Health and Science University, local community hospitals and 16 other major research hospitals across the nation, and involved more than 4,000 paramedics and 893 patients.

Epileptic seizures cause 55,000 deaths each year. The study's findings are important because it can be very difficult to administer a drug intravenously to a patient experiencing seizures; giving an intramuscular shot is easier, faster and more reliable - and thus could save lives.

'Getting treatment quickly to people suffering these seizures is vital to prevent potential brain injury, and this study establishes that the auto-injector is a very quick way to deliver the medicine and it is safe and effective,' said Craig Warden, M.D., M.P.H., an emergency physician at OHSU, medical director for Clackamas Fire and the site principal investigator for the study.

The study - called the Rapid Anticonvulsant Medication Prior to Arrival Trial, or RAMPART - tested a device similar to an EpiPen, commonly used by people with severe allergies. Researchers wanted to determine whether administering a drug called midazolam through the EpiPen-like device was as safe and effective as giving another type of medicine - lorazapam - through an IV into the vein. Administering lorazapam through an IV is currently the standard of care for such seizures. The study, which was carried out by paramedics, compared how well each method and drug stopped patients' seizures by the time the ambulance arrived at a hospital's emergency department.

The study found that 73 percent of patients in the group receiving midazolam were seizure-free upon arrival at the hospital, compared to 63 percent of patients who received IV treatment with lorazapam. Patients treated with midazolam were also less likely to require hospitalization than those receiving IV lorazapam. Among those admitted, both groups had similarly low rates of recurrent seizures.