Don't Forget the Bubbles
JANUARY 24, 2024
Four-year-old Fern is a previously healthy girl who presents with a febrile illness and seizures. Seizure activity did not respond to either first or second-line treatments, so she needed rapid sequence induction and transfer to PICU for ongoing anaesthesia and management. What causes Super Refractory Status Epilepticus?
ALiEM
MARCH 5, 2024
Cases of toxicity have been reported following ingestion of supplements as well as ingestion of willow bark tea [4,5]. With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Willow tree bark supplements are available as tablets, tinctures, powders, or tea.
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EMDocs
NOVEMBER 6, 2023
Patients with severe agitation from sympathomimetic poisoning require sedation to manage hyperthermia and acidosis, to prevent rhabdomyolysis and injury, and to allow evaluation for other life-threatening conditions. Flumazenil administration is associated with harm in patients who are at increased risk for seizures or dysrhythmias.
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. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. EMS reported an initial GCS of 8 with pupils equal and reactive.
Taming the SRU
AUGUST 25, 2023
bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2
Taming the SRU
APRIL 13, 2023
Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.
Pediatric Education
MAY 7, 2023
The fever was responsive to antipyretics, and he was taking some dextromethorphan as well. Malignant hyperthermia is associated with inhaled anesthetics and some muscle relaxants and occurs usually very suddenly within minutes to hours. Maximum temperature was 102.4F 5 days ago. Resolution is also longer (9 or so days).
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