How did you hear about this survey?
What is your training background?
What other medical or healthcare training background do you have?
How are you involved in the clinical care of patients with SRSE?
Please select all that apply.
If you selected that you are not involved in clinical care, please describe your role.
What is your clinical role?
Advanced Practice Provider (NP, PA) Physician Pharmacist Other
If you selected Other as your clinical role, please type in your role pertaining to SRSE.
How many years have you been in practice?
I am in training (resident/fellow) Less than 5 years 5-10 years Greater than 10 years
United States
Outside of United States
In which part of the United States do you practice?
North-East (ME, NH, VT, MA, RI, CT)
Mid-Atlantic (NY, NJ, PA, DE, MD, VA, WV)
South-East (NC, SC, GA, FL, AL, MS, LA, AR)
Midwest (OH, IN, KY, MI, WI, IL, MN, IO, MO, ND, SD, NE, KS)
South-West (OK, TX, CO, NM, UT, AZ)
North-West (WA, OR, ID, MT, WY)
West (CA, NV)
Alaska
Hawaii
US territory
In which global region do you practice?
Europe
Asia
Africa
Oceania
Latin America
North America
Middle East
In what setting is your institution?
Urban
Suburban
Rural
Please describe the institution in which you practice
Teaching hospital
Non-teaching hospital
Does your institution have a dedicated neurosciences ICU?
Yes
No
How many beds does your neurosciences ICU have?
1-10
11-20
21-30
31-40
41-50
More than 50
Is continuous video electroencephalography (cvEEG) available at your institution?
Yes
No
Which service makes treatment recommendations for RSE and SRSE?
If other, please type which service makes recommendations for SRSE management
Please select all the therapies for SRSE (excluding anti-seizure medications and intravenous anesthetics) that are available at your institution for potential use.
Please type other therapy for SRSE are available at your institution. Please do not include anti-seizure medications.
Please type other therapy for SRSE are available at your institution. Please do not include anti-seizure medications.
Please type other therapy for SRSE are available at your institution. Please do not include anti-seizure medications.
Please type other therapy for SRSE are available at your institution. Please do not include anti-seizure medications.
In your opinion, is there practice variation in strategies managing SRSE amongst providers at your institution?
Yes
No
Which of the following adjunct anti-seizure medications are available at your institution (excluding levetiracetam, valproic acid, phenytoin/fosphenytoin)?
Please type other anti-seizure medication available for adjunct therapy at your institution (excluding levetiracetam, valproic acid, phenytoin/fosphenytoin).
Please type other anti-seizure medication available for adjunct therapy at your institution (excluding levetiracetam, valproic acid, phenytoin/fosphenytoin).
Please type other anti-seizure medication available for adjunct therapy at your institution (excluding levetiracetam, valproic acid, phenytoin/fosphenytoin).
Please type other anti-seizure medication available for adjunct therapy at your institution (excluding levetiracetam, valproic acid, phenytoin/fosphenytoin).
What is your typical practice once you deem an anti-seizure medication to be ineffective at controlling SRSE?
I will typically discontinue the medication and select an alternative agent
I will typically continue the medication and add another agent
I do not have a typical practice for this situation
Once SRSE is controlled, how often will you wean anti-seizure medications in the acute setting (prior to hospital discharge)?
Never
Rarely
Sometimes
Often
Always
What level of suppression do you typically target when treating SRSE?
Seizure suppression only
Burst suppression
Total suppression
Once achieving ______ how long will you typically continue until attempting to wean?
Which anesthetic drugs are available at your institution for management of status epilepticus?
What other anesthetic is available at your institution for management of status epilepticus?
At what dose of your first choice agent will you typically add your second choice agent?
How many hours of escalating anesthetic dosage (including multiple anesthetics) without seizure control/suppression until you would consider adjunctive therapies?
Less than 24 hours
24-48 hours
48-72 hours
72-96 hours
96-120 hours
Greater than 120 hours
I base my decision on the number of unsuccessful weans of anesthetics rather than duration of anesthetics.
I would not consider using adjunctive therapies
How many unsuccessful weans of anesthetics until you decide to add adjunctive therapies?
0
1
2
3
4
5
6
7
8
9
10 or more
CSF for basic profile and cultures
Rapid CSF infectious panel
Advanced CSF testing (e.g. 16s analysis or metagenomic sequencing)
CSF autoimmune, encephalopathy, paraneoplastic panels
Serum autoimmune, encephalopathy, paraneoplastic panels
CT scan for malignancy (chest, abdomen, pelvis)
Scrotal or transvaginal ultrasound
Please describe any challenges or limitations in resources in the management of SRSE at your institution. (Free response)
If you could have one additional therapy available at your center to treat SRSE, which would you prefer?
Brivaracetam Cenobomate Clobazam CSF drainage Electroconvulsive therapy Hypothermia Immunotherapy (steroids) Immunotherapy (IVIG) Immunotherapy (plasmapheresis) Immunotherapy (Anakinra) Immunotherapy (Tocilizumab) Inhaled anesthetics Ketogenic diet Modified Atkins diet Lidocaine Magnesium Perampanel Prolonged CIVADs Pyridoxine Surgical resection TMS/tDCS Vagal nerve stimulation I have all these therapies at my institution I do not feel that adding any therapy would be useful I would like to add a therapy not listed
Please indicate the SRSE therapy you would add at your institution if able
Do you use the Status epilepticus severity score (STESS) , Epidemiology-based mortality score in status epilepticus (EMSE ), or other clinical scores to guide prognostication in SRSE? (Abbreviations are hyperlinks to the scores)
Yes
No
Do you feel you can accurately predict the likelihood of good functional recovery in a patient with SRSE?
Yes
No
How do you determine futility in SRSE? (Free response)
After how many weeks of uncontrolled SRSE, defined as inability to wean from anesthetics, would you consider futility in further escalation in the case of the 25 year-old patient described above?
After how many weeks of persistent coma following cessation of SRSE and weaning from anesthetics would you consider approaching the patient's surrogates to advocate considering withdrawal of life sustaining therapies in the case of the 25 year-old patient described above?
Do you feel that you are able to offer a prognosis to the patient's surrogate(s)?
Yes
No
After how many weeks of uncontrolled SRSE, defined as inability to wean from anesthetics, would you consider futility in further escalation in the case of the 70 year-old patient described above?
After how many weeks of persistent coma following cessation of SRSE and weaning from anesthetics would you consider approaching the patient's surrogates to advocate considering withdrawal of life sustaining therapies in the case of the 75 year-old patient described above?
Do you feel that you are able to offer a prognosis to the patient's surrogate(s)?
Yes
No
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