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Local extubation in children with status epilepticus
- Dr Kokul SriskandarajahChelsea and Westminster Hospital
Key points
- Nine children with status epilepticus could not be extubated locally because of a lack of knowledge of the guidelines.
- After teaching and discussion of the Children's Acute Transport Service guidelines, two children were extubated locally.
- Local extubation avoids unnecessary transport to paediatric intensive care and the costs involved, and can be adopted by other trusts.
Dr Kokul Sriskandarajah, Chelsea and Westminster Hospital, provides insights into a project focused on improving the management of children with status epilepticus at a busy district general hospital in London. The discussion highlights a study conducted both prospectively and retrospectively, following the introduction of new guidelines for local extubation in children who require intubation due to prolonged seizures. Dr Sriskandarajah describes how, prior to guideline implementation, nine children could not be extubated locally due to a lack of clinician knowledge and awareness of the guidelines. After targeted teaching and discussion of the Children’s Acute Transport Service guidelines, the team was able to safely extubate two children locally, thereby avoiding unnecessary transfers to paediatric intensive care and conserving valuable PICU beds in London. He emphasizes that this approach can be adopted by other trusts, supporting safe, local extubation for children with status epilepticus and improving resource utilization. This interview took place at the RCPCH conference 2025 in Glasgow, Scotland.
Read the transcript
Automatic transcript, lightly edited for readability. It may contain errors, so check it against the video before quoting.
So today we presented a poster about local extubation in status epilepticus in children. We conducted a study at a busy district general hospital in London looking at children who have come in with prolonged seizures and children that need to be intubated and whether we could extubate children locally at our trust. So we conducted this prospectively and retrospectively following introduction of guidelines.
After we implemented new guidelines and had a talk about extubation using the Children's Acute Transport Service guidelines, we were able to extubate children locally. So initially we had nine children who came in with status epilepticus who were unable to extubate because of lack of knowledge, no idea about the guidelines etc.
Following implementation of new discussion about the guidelines, teaching about the guidelines, we then were able to extubate two children locally, therefore avoiding unnecessary transport to paediatric intensive care and the costs involved with that and precious PICU beds in London. So this is something that can be adopted by a lot of different trusts just following the simple guideline to allow them to extubate children locally who are coming in with status epilepticus.
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Cite this video
Dr Kokul Sriskandarajah. “Local extubation in children with status epilepticus.” The Paediatric Video Journal, 23 June 2025. https://paediatricvj.com/videos/local-extubation-in-children-with-status-epilepticus-sriskandarajah/
This interview is educational content intended for healthcare professionals and is not medical advice. Views expressed are those of the speaker. © The Paediatric Video Journal. All rights reserved.