A descriptive study of the experiences of relatives/carers with the use of buccal midazolam in the community setting

Background: Prolonged seizures can increase the risk of status epilepticus which is potentially harmful and life threatening. Buccal midazolam (BM) is recognized as an effective, safe and acceptable form of first-line... [ view full abstract ]

Background:
Prolonged seizures can increase the risk of status epilepticus which is potentially harmful and life threatening. Buccal midazolam (BM) is recognized as an effective, safe and acceptable form of first-line treatment for prolonged seizures in the pre-hospital setting. The person most commonly responsible for administration of BM is the relative or carer of the person with epilepsy. However there are a limited number of studies in the literature examining the use of BM from the relative/carers perspectives.

Aims and objectives:
The purpose of this study is to explore and describe the experiences of relatives/carers with the use of buccal midazolam in the community setting.

Method:
A qualitative descriptive design was employed. Semi-structured telephone interviews were used for data collection and a total of 16 interviews were undertaken. Data analysis was performed using Colazzi's Data Analysis Framework (1978). Ethical approval was granted by the author's institution research and ethics committee.

Findings:
Participants reported anxiety and distress when faced with seizures in the community. Many of participants found BM easy to use and effective in stopping seizures. Many reported that BM made them feel safe and reassured and reduced emergency department attendances. However there was a significant lack of awareness of time in relation to the duration of seizures and when BM should be administered. Despite having been informed about BM by clinicians there was a knowledge deficit amongst participants in regards to BM administration, its actions, potential side effects, dosing and seizure response.

Conclusion and implications:
Dealing with seizures can be a stressful experience with associated negative emotions for the relative/carer. They require comprehensive education on recognition of seizures, appropriate response to seizures and BM administration so that they can manage these situations more effectively. A variety of training methods should be considered to cater for the varying educational needs of relatives/carers as well as supportive documentation such as individualized seizure care plans.