Healthcare-seeking behavior after seizures in children.

ABSTRACT

Background: Hardly any Indian data is available regarding practices employed by parents for preventing injuries and aspiration and controlling convulsions in children. Aims: To describe the health care-seeking behavior and practices employed by parents when a child has convulsions. Settings and Design: Prospective questionnaire-based study in a tertiary care hospital setting. Materials and Methods: Parents of children (age 1 month -12 years) admitted with history of convulsions were enrolled and information regarding demographic characteristics, time lag, preferred health care provider and measures taken in a convulsing child was elicited using a pretested questionnaire. Statistical Analysis Used Demographic parameters and measures employed described as percentages. Results: One hundred and forty parents were interviewed. Seventy-six children had first episode. Forty-nine of 64 children with subsequent seizures had contact with a health care provider during the previous seizure episode. The median duration of seizures was 10 minutes (Mean 54.15+/-366.39 min); but children were brought to the hospital after a median of 2 hours (Mean 5.22+/-10.37 h). Measures such as smelling onions, oral administration of cold water, reading religious texts and insertion of mouth gag were employed. Although 45 with previous seizure-related health care contact agreed that they were informed about measures to be taken, none of them could remember more than one measure for preventing injuries and aspiration and controlling seizures. Only four narrated "per-rectal administration of diazepam" as a measure, although only one implemented it. Only four general practitioners used per-rectal diazepam to control seizures. Conclusions: Children with seizures reach health care providers after a considerable delay putting them at higher risk for developing neurological sequel. There is a need to develop appropriate strategies for disseminating information about "first aid" measures and steps for controlling convulsions and imparting relevant skills to parents.