Taming the SRU

FEBRUARY 5, 2024

Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2]. 2012 Jan 15;85(2):123-32. In patients with an abnormal CT Head, decisions regarding management and disposition should be made in conjunction with a Neurosurgeon. JAMA Pediatr. 2021;175(11):1124–1131.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4,

Sepsis 66

Sepsis Shock Resuscitation Fluid Resuscitation 66

Taming the SRU

MARCH 31, 2023

Charon, Academic Med 2012) embracing fear in emergency medicine WITH dr. arlene chung What is fear? Narratives trigger changes of many kinds in both the teller and the listener, yielding meanings that are reciprocally produced by each teller-listener dyad.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Taming the SRU

MARCH 14, 2023

Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. The seizure abated with rectal diazepam given by the squad. You notice a med-alert bracelet with the patient’s name and the word “SEIZURES.” His abdomen is soft. Neuroradiology. Amer J Rad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Definition of status epilepticus:Continuous seizure activity of 5 minutes or greater – OR – Recurrent activity without recovery between intervals. This definition includes clinically apparent seizures as well as those seen only on EEG.) During a seizure, GABA receptors in the neuron’s membrane are internalized and destroyed.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Dr. Smith's ECG Blog

JANUARY 21, 2023

The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. Europace 2012 Shinde R, Shinde S, Makhale C, Grant P, Sathe S, Durairaj M, Lokhandwala Y, Di Diego J, Antzelevitch C. Seizure activity was witnessed in the ED.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neuroscience and Biobehavioral Reviews. 2005; 29: 493–500. Panebianco M, Rigby A,Weston J,Marson AG. Cochrane Database of Systematic Reviews. 2015; 4, Art. J Amer Coll Cardiol.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Downeast Emergency Medicine

APRIL 26, 2021

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

EMDocs

JULY 19, 2023

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. Mercury levels in commercial fish and shellfish (1990-2012). Resources: S. Food and Drug Administration. 2022, February 25).

Poisoning 65

Poisoning Fluid Resuscitation Administration Seizures 65

Pediatric Emergency Playbook

JUNE 1, 2017

The Systemic Lupus International Collaborating Clinics (SLICC) revised the criteria in 2012. The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI. 2012; AID 471759. 2012; 7:19796.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2016

S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. 2012; 33:1040–1045. ACCF 2012 Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations. 2012; 60(23): 2427-2463. 2012; 19:1276–1280. 2014; 14:83.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Downeast Emergency Medicine

MARCH 24, 2021

Incubation typically 2-5 days, with illness lasting up to 10 days Association with Guillain-Barre syndrome Shigella Raw and unwashed vegetables Most common to get passed around daycare Seizures, AMS, coma Rectal prolapse possible from excessive diarrhea Fecal shedding E. Clin Infect Dis 2012, 55(7):897-904. Pubmed ]

Pediatrics 52

Pediatrics Dehydration Emergency Department Wellness 52

Pediatric Emergency Playbook

MAY 1, 2017

Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. 2012; 129(4). 2012 Aug;130(2):e352-7. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Check the bilirubin in any neonate you are working up for sepsis. J Clin Neonatol. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. 2012 Jul-Aug;8(4):237-41. Right Dose – Dosing with IN meds will vary considerably from the IV route. Rule of thumb: the IN dose is 2-3 times the IV dose. J Opioid Manag.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

EB Medicine

AUGUST 1, 2018

Jeff: Medicinally, cannabinoids are currently used in the treatment of chronic pain syndromes, complications of multiple sclerosis and paraplegia, weight loss due to appetite suppression in HIV/aids, chemotherapy-induced nausea and vomiting, seizures, and many other neuropsychiatric disorders.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

NOVEMBER 13, 2023

Lancet Neurol 2012, 11 (4), 307-314. J Trauma Acute Care Surg 2012, 72 (2), 330-335; discussion 336-337, quiz 539. Arch Neurol 2012, 69 (3), 346-351. CTA head/neck is absolutely indicated if suspicion is high for this condition. 46 All of these states are some gradation of consciousness impairment. 21) Romero, J. Artunduaga, M.;

Stroke 85

Stroke Radiology Radiology Emergency Department 85

Dr. Smith's ECG Blog

DECEMBER 5, 2019

J Electrocardiology 45 (2012):433-442. Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Bayes de Luna, A et al. Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Don't Forget the Bubbles

JULY 26, 2023

Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. The majority of the inherited rhythm disorders are autosomal dominant but their diagnosis relies on an electrically active heart.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

EB Medicine

FEBRUARY 1, 2019

Nachi: Unfortunately, the 2008 ACEP guideline and 2012 AHA guidelines still recommend a lumbar puncture in those being worked up for SAH. Seizures are very common as well. That’s quite a list. For a visual reference, see Table 3 in the print issue. In addition, one 2016 study demonstrated a LR of 0.01

Emergency Department 40

Emergency Department Stroke Outcomes Wellness 40