ARE SPINAL PRECAUTIONS NECESSARY IN ALL SEIZURE PATIENTS

The purpose of this retrospective chart review study was to evaluate t he necessity of spinal precautions in uncomplicated seizure patients. The population was all patients from the Emergency Department with a p rimary diagnosis of seizure over a 10.5-year period. The setting was a university-affiliate county teaching hospital with an annual patient volume or over 58,000, The key outcome measure was an association of s pinal injuries to uncomplicated seizures. A total of 1,656 cases were reviewed, No spinal injuries were found. Three nonspinal fractures wer e associated with seizure activity. Transportation costs increased app roximately 113% and nursing costs increased approximately 57% for pati ents with seizure placed in spinal precautions. Duality Assurance and Risk Management files showed no complaints or litigation secondary to missed spinal injuries. This retrospective chart review study seriousl y questions routine use of spinal precautions in uncomplicated seizure cases. If spinal precautions were not used in this group, there would be a significant potential cost savings without increased morbidity. A prospective study is needed to confirm these findings. (C) 1995 by W .B. Saunders Company