Baustein Rückmeldung (I): Rückmeldungen gestalten

Eine schulische Projektgruppe hat sich entschlossen, eine Selbstevaluation durchzuführen: Sie formuliert die Ziele ihres Vorhabens, sucht nach passenden Indikatoren für die Zielerreichung und nach der Methode der Wahl, um diese zu messen. Schließlich liegen die Ergebnisse vor. Doch damit ist die Selbstevaluation noch nicht abgeschlossen. Nun gilt es die gewonnenen Daten nutzbar zu machen. In diesem Demokratie-Baustein wird in die Gestaltung von Rückmeldeprozessen eingeführt

Baustein Rückmeldung (II): Ergebnisse sichtbar machen

Am Ende der Erhebungsphase liegt in der Regel unterschiedliches Datenmaterial aus einer Vielzahl von Quellen vor. Die darzustellenden Ergebnisse sollten dann so aufbereitet und beschrieben werden, dass das Charakteristische leicht erkannt werden kann. Dazu kann man sich verschiedener Tabellen und Grafiken zur Veranschaulichung bedienen

Selbstevaluation für Schulleitungen

In diesem Demokratie-Baustein geht es zum einen um die Möglichkeiten für eine Selbstevaluation der Schulleitung unter dem Aspekt "Demokratische Schulkultur" und zum anderen um die Aufgaben, die Schulleitung in Bezug auf die Entwicklung einer Selbstevaluationskultur an einer Schule hat. Dabei werden neben konkreten Verfahren (z.B. Fragebögen oder Jahresgespräche) auch die Erfahrungen von Schulleiter/-innen aus den BLK-Programmschulen mit der Selbstevaluation vorgestellt

Demokratiebaustein: Rückmeldung (III): Gemeinsam Schlussfolgerungen ziehen

Nachdem das Datenmaterial ausgewertet ist, müssen die damit vorliegenden Ergebnisse an die (Schul-) Öffentlichkeit zurückgemeldet werden. Nun folgt die gemeinsame Analyse und Diskussion der Evaluationsergebnisse

Status epilepticus during the COVID-19 pandemic in Cologne, Germany: data from a retrospective, multicentre registry

BACKGROUND: The “coronavirus disease 2019” (COVID-19) pandemic, caused by the “severe-acute-respiratory-syndrome-coronavirus 2” (SARS-CoV-2), challenges healthcare systems worldwide and impacts not only COVID-19 patients but also other emergencies. To date, data are scarce on the extent to which the COVID-19 pandemic impacted status epilepticus (SE) and its treatment. OBJECTIVE: To assess the influence of the COVID-19 pandemic on the incidence, management and outcome of SE patients. STUDY DESIGN: This is a retrospective, multicentre trial, approved by the University of Cologne (21-1443-retro). METHODS: All SE patients from the urban area of Cologne transmitted to all acute neurological departments in Cologne between 03/2019 and 02/2021 were retrospectively analysed and assessed for patient characteristics, SE characteristics, management, and outcome in the first pandemic year compared to the last pre-pandemic year. RESULTS: 157 pre-pandemic (03/2019–02/2020) and 171 pandemic (from 03/2020 to 02/2021) SE patients were included in the analyses. Acute SARS-CoV-2 infections were rarely detected. Patient characteristics, management, and outcome did not reveal significant groupwise differences. In contrast, regarding prehospital management, a prolonged patient transfer to the hospital and variations in SE aetiologies compared to the last pre-pandemic year were observed with less chronic vascular and more cryptogenic and anoxic SE cases. No infections with SARS-CoV-2 occurred during inpatient stays. CONCLUSIONS: SARS-CoV-2 infections did not directly affect SE patients, but the transfer of SE patients to emergency departments was delayed. Interestingly, SE aetiology rates shifted, which warrants further exploration. Fears of contracting an in-hospital SARS-CoV-2-infection were unfounded due to consequent containment measures. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11260-2

Status epilepticus and benzodiazepine treatment: Use, underdosing and outcome - insights from a retrospective, multicentre registry

Objective: To explore the reasons for and outcomes of non- or undertreatment with benzodiazepines (BZDs) in status epilepticus (SE).Methods: We retrospectively analysed all SE patients from the urban area of Cologne over two years.Results: 328 SE patients were eligible, and only 72% were initially treated with BZDs. Of these, only 21.6% were treated sufficiently with BZDs according to current guidelines. SE patients not initially treated with BZDs were significantly older, had less often known epilepsy, had a prolonged arrival time to the emergency room, and presented more often with a non-generalised convulsive semiology. Regarding adequate dosages, patients with a generalised convulsive SE seemed to benefit from a sufficient BZD dosing with significantly shortened mean ventilation duration (37.1 to 208 h), decreased mean intensive care unit (1.7 to 5 days) and in-hospital stay (4.1 to 8.8 days). In contrary, aggressive BZD treatment in non-generalised convulsive SE resulted in a longer inpatient stay (9.2 to 5.8 days) and lower favourable outcome rates at discharge (16% to 63%).Conclusions: The current SE treatment guidelines for first-line BZD therapy in SE were violated in most patients. Sufficient BZD dosing was beneficial in generalised convulsive SE, but not in other forms of SE. SE semiology might be crucial for treatment decisions with BZDs. Further treatment evidence especially in non-generalised convulsive SE is urgently needed.Keywords: Anticonvulsants; Benzodiazepines; Critical care; Guideline adherence; Seizures

Prehospital Levetiracetam Use in Adults With Status Epilepticus: Results of a Multicenter Registry

Background and PurposeStatus epilepticus (SE) is a neurological emergency due to prolonged seizure activity or multiple seizures without full recovery in between them. Prehospital SE management is crucial since its duration is correlated with higher morbidity and mortality rates. We examined the impact of different therapeutic strategies in the prehospital setting with a focus on levetiracetam.MethodsWe initiated the Project for SE in Cologne, a scientific association of all neurological departments of Cologne, the fourth-largest city in Germany with around 1,000,000 inhabitants. All patients with an SE diagnosis were evaluated over 2 years (from March 2019 to February 2021) to determine whether prehospital levetiracetam use had a significant effect on SE parameters.ResultsWe identified 145 patients who received initial drug therapy in the prehospital setting by professional medical staff. Various benzodiazepine (BZD) derivatives were used as first-line treatments, which were mostly used in line with the recommended guidelines. Levetiracetam was regularly used (n=42) and mostly in combination with BZDs, but no significant additional effect was observed for intravenous levetiracetam. However, it appeared that the administered doses tended to be low.ConclusionsLevetiracetam can be applied to adults with SE in prehospital settings with little effort. Nevertheless, the prehospital treatment regimen described here for the first time did not significantly improve the preclinical cessation rate of SE. Future therapy concepts should be based on this, and the effects of higher doses should in particular be reexamined. Keywords:neurological emergency; prehospital setting; anticonvulsant therapy; benzodiazepines; levetiraceta