Aanbevelingen voor de behandeling van urgente aandoeningen in de eerste lijn: convulsies, anafylaxie en agitatie in urgente situaties

Abstract

Recommendations for the treatment of emergencies in primary care: seizures, anaphylaxis and agitation General practitioners are frequently confronted with urgent medical situations both during and outside office hours, requiring a quick and accurate response. This article presents a summary of the recommendations for the treatment of emergencies (part 1), specifically addressing the management of seizures, anaphylaxis and agitation. These recommendations are an update of the 2008 guidelines of Domus Medica and were developed by the national Working Group for the Development of Guidelines in Primary Care (WOREL) according to internationally recognized methods for guideline development. The focus of the recommendations is the pharmacological management by the general practitioner. If necessary, diagnostics are briefly discussed. The aim is to inform general practitioners about the recommended content of the emergency kit, as well as the recommended dosages and administration routes for the most common indications. For the treatment of prolonged seizures, benzodiazepines should be administered, with intramuscular midazolam as first choice. In the case of anaphylaxis, immediate intramuscular administration of adrenaline and, if available, high-flow oxygen is recommended. If the response is inadequate, short-acting β2-agonists should be administered via inhalation. For agitation likely due to psychosis, an oral antipsychotic or benzodiazepine should be considered. If there are no suspicions or signs of a psychosis, only benzodiazepines are recommended. Oral administration is preferred when the patient presents with agitation, unless in case of severe agitation with a risk to oneself or others. Then, intramuscular administration is preferred. Via https://www.ebp-guidelines.be/home the full guideline in English can be consulted.