First-aid management of tonic-clonic seizures among healthcare personnel: A survey by the Apulian section of the Italian League Against Epilepsy Tommaso Martino, Alessandra Lalla, Elena Carapelle, Maria Teresa Di Claudio, Carlo Avolio, Giuseppe d'Orsi ⁎, On the behalf of #SorprenderEpilessia Collaborative Group of Apulian Section of Italian League Against Epilepsy (LICE): G. d'Orsi a , T. Martino a , A. Lalla a , E. Carapelle a , M.T. Di Claudio a , C. Avolio a , G. Pustorino b , A.N. Polito b , A. La Neve c , T. Francavilla c , G. Boero d , G. Pontrelli d , S. Internò d , S. Patanè e , M. Germano f , L. La Selva g , V. Sciruicchio g , V. Durante h , R. Scarpello h , M. Elia i a Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy b Department of Child Neuropsychiatry, Riuniti Hospital, Foggia, Italy c Epilepsy Center, Neurology Clinic, University of Bari, Bari, Italy d Department of Neurology, SS. Annunziata Hospital, Taranto, Italy e Unit of Child Neuropsychiatry, Local Health Authority, Lecce, Italy f Maternal and Pediatric Department, IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy g Centre of Developmental Epilepsy and Electroencephalography, Fallacara Hospital, Triggiano, BA, Italy h Department of Neurology, F. Ferrari Hospital Unit, Casarano, LE, Italy i Pediatric Neurology Clinic, Local Health Authority, Brindisi, Italy Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy abstract article info Article history: Received 15 August 2017 Revised 15 November 2017 Accepted 19 November 2017 Available online xxxx Introduction: To evaluate the knowledge of healthcare workers about first-aid measures to be performed during and after a tonic–clonic seizure. Methods: One hundred and fifty-four healthcare workers (86 physicians) working at 8 tertiary hospitals in the Apulia region, Italy, responded to a questionnaire comprising of 28 questions based on available Italian and international recommendations about what to do during a tonic–clonic seizure. Results: One hundred and fifty-four healthcare workers completed and returned surveys with a response rate of 96.25%. There were 55 nurses (35.7%), 86 physicians (55.8%), and 13 healthcare workers with different roles (Electroencephalograph technicians, psychologists, social workers). Among physicians, there were 7 cardiolo- gists, 3 surgeons, 12 infectious-disease specialists, 11 internal medicine specialists, 2 psychiatrists, 2 gynecolo- gists, 27 specialists working in the emergency department, and 22 physicians with different specializations. Nearly 90% of the respondents identified head protection as important first aid, while 100% responded to not keep the legs elevated. To avoid tongue bite, both physicians and other healthcare workers would put something in the mouth (54.0%), like a Guedel cannula (71.0%) fingers (29.5%). Grabbing arms and legs, trying to stop the seizure, would be potentially performed by 11.6% of our sample. Physicians would administer a benzodiazepine during the seizure (65.7%) and during the postictal phase (29.2%), even if the patient is known to have epilepsy (23.7%), and in this case, 11.3% of respondents would administer the usual antiepileptic medications. More than half of respondents would call the emergency telephone number, because of necessary hospitalization in case of tonic–clonic seizure, even if it is experienced by a patient known to have epilepsy. Conclusion: Our survey suggests the need for epilepsy educational programs on first-aid management of seizures among healthcare workers. © 2017 Elsevier Inc. All rights reserved. Keywords: Tonic–clonic seizure Healthcare personnel First-aid seizure management Tongue bite Epilepsy educational programs Epilepsy & Behavior xxx (2017) xxx–xxx ⁎ Corresponding author at: Department of Neurological Sciences, Epilepsy Center, Clinic of Nervous System Diseases, Riuniti Hospital, Via Luigi Pinto 1, 71100 Foggia, Italy. E-mail address: gdorsi@ospedaliriunitifoggia.it (G. d'Orsi). YEBEH-05578; No of Pages 5 https://doi.org/10.1016/j.yebeh.2017.11.017 1525-5050/© 2017 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh Please cite this article as: Martino T, et al, First-aid management of tonic-clonic seizures among healthcare personnel: A survey by the Apulian section of the Italian League Against Epilepsy, Epilepsy Behav (2017), https://doi.org/10.1016/j.yebeh.2017.11.017