Current Environment:


1. Design an educational quality improvement program to assess the most effective educational approach on caregiver seizure RM application. The investigators hypothesize that this educational program will improve caregiver comfort, knowledge of emergent seizure care, and time to medication application. Specifically, the aims include: Create an educational video reviewing RM administration Develop and validate a simulation training model/mannequin for rectal diazepam administration Expand training to other seizure RMs (e.g. intranasal midazolam, buccal lorazepam) and transition the most effective educational model back to the clinics/bedside to standardize caregiver teaching throughout the department/hospital


Status Epilepticus

Recruitment Status


Detailed Description

The investigators will implement an intervention jointly with a simulation program to determine the most effective training model: verbal instructions, instructional video, or use of a mannequin. Caregivers will undergo a training curriculum, and 60 caregivers (20 assigned to each educational model) will be matched into three groups and assigned to participate in one of three educational models in the SIM Center. Pre-and post-training questionnaires will be distributed to assess provider knowledge and comfort level. Scoring of caregiver technique administering rectal diazepam to a mannequin and time to RM administration will be obtained to compare between the three educational arms of the study. Thirty additional patients (10 per group) will not receive an assessment of caregiver technique administering RM to the mannequin prior to the educational intervention to control for exposure to the mannequin. Ultimately, the most effective educational method in this simulation pilot study will be expanded to other RM types (e.g. intranasal midazolam, buccal lorazepam), standardized, and brought back to the clinics/bedside throughout the hospital.

Eligibility Criteria

Inclusion Criteria:

Adult caregivers of patients with epilepsy followed at BCH with the following:

At least one seizure >5 minutes
Prescription for rectal diazepam rescue medication
Admission for seizure/neurologic problem or neurology/epilepsy clinic visit during the enrollment period
Adult caregivers of patients without epilepsy

Exclusion Criteria:

Adult caregivers of epilepsy patients without a rectal diazepam prescription
Non-English-speaking caregivers


Intervention Type

Intervention Name


Verbal Instructions Educational Intervention


Video Educational Intervention


Mannequin Educational Intervention


Not Applicable



Min Age

2 Years

Max Age

80 Years

Download Date

September 4, 2020

Principal Investigator

Tobias Loddenkemper

Primary Contact Information

For more information on this trial, visit


For more information and to contact the study team:

Seizure Rescue Medication: Caregiver Education in a Simulation Setting NCT03562351