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C.5 Highlighting a novel, stepwise pathway for the in-hospital management of children with acutely worsening dystonia

Published online by Cambridge University Press:  05 June 2023

LM Vogt
Affiliation:
(Toronto)*
K Yang
Affiliation:
(Toronto)
G Tse
Affiliation:
(Stanford)
C Gorodetsky
Affiliation:
(Toronto)
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Abstract

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Background: Dystonia is common in children with acquired and inherited neurological disorders. Status dystonicus (SD) is the most severe form of dystonia that can lead to life-threatening complications if not treated promptly. We identified a local provider knowledge gap in the acute management of dystonia, leading to uncertainty and delays in care. To our knowledge, no in-hospital clinical pathway exists for the ward-based management of acute dystonia. We hypothesized that a stepwise clinical pathway would standardize and improve comfort in managing hyperacute dystonia. Methods: We formed a multidisciplinary working group and developed a pathway based on literature review and expert consensus. Aims of the pathway included: reducing delays in recognition and treatment of acute dystonia, limiting variation in management, and decreasing progression to SD. A survey was administered to providers assessing knowledge and comfort post-implementation. Results: There has been high usability with 58% (18/31) of providers surveyed having used the pathway at least once. Provider comfort has improved, with 89% (25/28) of respondents reporting increased comfort managing SD due to the clarity of the pathway and stepwise directions. Conclusions: The pathway fills a gap in the in-hospital management of dystonia and has led to increased provider comfort.

Type
Abstracts
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation