JournalFeed

APRIL 24, 2021

We cover leadership through change, IN midazolam for pediatric seizure, hypothermia and young infant sepsis risk, VICTAS RCT, and clinically diagnosing GHB intoxication. It’s the JournalFeed Podcast for the week of Apr 19-23, 2021.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Seizures Sepsis Leadership 52

Don't Forget the Bubbles

JANUARY 29, 2024

A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Despite this, the CFAM still showed ongoing electrical seizure activity.

Seizures 122

Seizures Pediatrics Research Wellness 122

The Skeptics' Guide to EM

DECEMBER 15, 2018

Acetaminophen and febrile seizure recurrences during the same fever episode. Pediatrics. He specialises in Paediatric Emergency Medicine and is a passionate […] The post SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen? Acetaminophen and febrile seizure recurrences during the same fever episode.

Seizures 52

Seizures Pediatrics Emergency Department Outcomes 52

Pediatric Education

FEBRUARY 18, 2024

There was no reported respiratory distress or problems handling secretions and no obvious seizure activity. Seizures, cerebrovascular problems and central nervous system tumor swirl in professionals’ heads as they take in the history, physical examination and start to evaluate and manage the problem. How are seizures classified?

Seizures 40

Seizures Pediatrics Psychiatric Radiology 40

Downeast Emergency Medicine

MARCH 24, 2021

OVERVIEW Diarrhea is a common complaint for our pediatric patients in the emergency department. Most pediatric diarrhea is not life threatening, and usually is treated with supportive care. However, there are important red flags to consider when assessing a pediatric patient with diarrhea. Pediatr Emerg Care 1997, 13(3):179-182.

Pediatrics 52

Pediatrics Dehydration Emergency Department Wellness 52

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) A systematic review of safety data for over 16000 pediatric patients did show MAEs were the most frequently reported event. 451 pediatric patients were included. From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. Pediatrics.

Pediatrics 130

Pediatrics Infectious Diseases Hospitals Seizures 130

Pediatric Education

APRIL 30, 2023

The past medical history showed she was a 38 week infant who had neonatal seizures that were easily controlled. She was weaned off antiepileptics after not having additional seizures several months later. How is pediatric stroke different than perinatal stroke? Otherwise she was described as a normally developing child.

Stroke 52

Stroke Seizures Pediatrics Hyperthermia / Hypothermia 52

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. In the US 95% of vaccine-eligible pediatric patients who travel are unvaccinated (McAteer 2021) Drug resistance has been developing over time. In addition to my passion for PEM, I also share a passion for global health.

Pediatrics 161

Pediatrics CDC Seizures Infectious Diseases 161

Taming the SRU

AUGUST 25, 2023

wrist in extension clavicle tibial pediatric forearm Most likely injuries to need an x-ray? 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

Seizures 66

Seizures Fractures EKG/ECG Resuscitation 66

EMDocs

JANUARY 17, 2024

5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9) 9) In 2019, benzonatate accounted for ~ 10% of all pediatric antitussive prescriptions dispensed via retail pharmacies. (9) 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9) Benzodiazepines are first-line therapy for seizures.

Poisoning 66

Poisoning Seizures Pediatrics Administration 66

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Get up-to-date in the understanding and management of pediatric status epilepticus. 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.)

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Taming the SRU

JANUARY 12, 2024

pediatric small groups WITH our cchmc colleagues Dermatologic emergencies Children can present with a wide range of rashes, many of which are benign, however identifying concerning rashes is very important. Use your resources to differentiate scary from benign! Children are not just small adults!

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Don't Forget the Bubbles

SEPTEMBER 13, 2023

Do not order laboratory testing or a CT scan of the head for a patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status. The parents of 18-month-old Susie brought her to the Emergency Department after she had a seizure at home. Investigators found that 99.3%

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

Don't Forget the Bubbles

JUNE 30, 2023

As in CRASH-2, TXA did not show a significant increase in thrombotic events or seizures. There was a small increased risk of seizures in the TXA group – 0.3% (7 children) of the 1900 children in the TXA group vs none of the 1900 children in the non-TXA group. Pediatr Crit Care Med. But that’s not where it ends.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2 mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2 mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

Pediatric Education

APRIL 28, 2024

A review can be found here Related Cases Disease: Cerebral Palsy Symptom/Presentation: Developmental Delay | Extremity Problems | Weakness Specialty: Developmental Disabilities | Neonatology | Neurology / Neurosurgery Age: Infant To Learn More To view pediatric review articles on this topic from the past year check PubMed. JAMA Pediatr.

Seizures 40

Seizures Pediatrics Dislocations Stroke 40

PEMBlog

MARCH 27, 2024

My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

ALiEM

NOVEMBER 15, 2023

1,6,7] Dizziness, confusion, headache Shortness of breath Weakness and malaise Nausea and vomiting Hypotension, seizures, coma, apnea, arrhythmias Death due to cardiorespiratory arrest How do you diagnose cyanide poisoning? [7] Dosing for 3% sodium nitrite solution [8]: Adults: 300 mg (10 mL) no faster than 5 mL/min Pediatrics: 6 mg/kg (0.2

Poisoning 67

Poisoning Pediatrics Seizures Administration 67

EMDocs

MARCH 2, 2024

 An Pediatr (Engl Ed). 2019 Seizure as Early Presentation of a Pneumocephalus after Cochlear Implant: A Case Report. J The most common causes include trauma and cranial surgeries, but there are other etiological factors, and in rare cases, it can also be spontaneous. [1-3] Int J Crit Illn Inj Sci. 2017  2017 Jan-Mar;7(1):58-64.

EMS 112

EMS Fractures Seizures Head Injuries 112

Pediatric EM Morsels

APRIL 7, 2023

There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Expert Rev Hematol. doi: 10.1586/ehm.13.25.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

Cook County EM Blog

MAY 29, 2023

Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. If a therapeutic dose is chewed, it can lead to bronchospasm, laryngospasm, seizures, and cardiovascular collapse which further reinforces the danger to children.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

EMDocs

NOVEMBER 6, 2023

Flumazenil administration is associated with harm in patients who are at increased risk for seizures or dysrhythmias. We recommend the use of benzodiazepines to treat seizures associated with local anesthetic systemic toxicity. Editorial Comment: Give atropine, benzo’s for seizures. COR No Benefit, LOE C-EO.

Poisoning 92

Poisoning Hyperthermia / Hypothermia Seizures Administration 92

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. Decades ago, psychiatric complaints in the pediatric ED were infrequent.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

Don't Forget the Bubbles

MARCH 18, 2024

A similar process can also occur in the CNS (causing seizures ), the liver and the pancreas. Depending on the progression of the illness, children may present with pallor, oedema, lethargy, seizures, hypertension or abnormal liver function tests. Pediatric Nephrology. What is atypical HUS? Though uncommon, HUS can be deadly.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Taming the SRU

FEBRUARY 5, 2024

For pediatric patients, we recommend using the PECARN Pediatric Head Injury Algorithm. Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2]. JAMA Pediatr. For high-risk patients, a non-contrast CT Head is the test of choice. JAMA Netw Open.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Taming the SRU

FEBRUARY 23, 2024

Clinical pathologic case presentation - r1 diagnostics/therapeutics: Lumbar punctures - AIRWAY GROUND ROUNDS- r4 capstone - r3 taming the sru - ultrasound grand rounds Clinical pathologic case presentation WITH Drs.

Pediatrics 68

Pediatrics Ultrasounds Wellness Fractures 68

EMDocs

JUNE 7, 2023

mg/kg pediatrics) Double dose every 5 min Titrate up to end point of therapy and may require very large doses Target End Point of Therapy = clear chest sounds, HR > 80/min, pupil size greater than pinpoint, and dry axillae. Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. See figure below.

Poisoning 81

Poisoning Airway Management Seizures PPE 81

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Later in the pediatric intensive care unit (PICU), he developed pulmonary edema, but he continued to improve neurologically. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Pediatric Education

MAY 21, 2023

Body rocking differential diagnosis also includes seizures, motor tics and other movement disorders such as ataxia, dystonia, myoclonus, tremor, Tourette syndrome, rhythmic movement disorder The Motor Sterotypy Severity Scale is one of several caregiver rating scales. Semin Pediatr Neurol. Semin Pediatr Neurol. 2018;25:19-24.

Seizures 40

Seizures Pediatrics 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.” Pediatr Emerg Care. His abdomen is soft.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

The Skeptics' Guide to EM

NOVEMBER 18, 2017

We have covered fever before on the SGEM in pediatric patients. There was the great episode on pediatric fever fear with PedEM Super Hero Anthony Crocco ( SGEM#95 ). We also did a RANThony on pediatric fever fear that you can watch on YouTube. Will treating with antipyretics prevent a febrile seizure?

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

Pediatric EM Morsels

NOVEMBER 3, 2023

ovale to cover the hypnozoite that can stay dormant in the liver and cause a secondary infection in the future Severe Malaria IV artesunate is currently the accepted first line treatment Previously IV quinine was first line, however it was associated with higher incidence of hypoglycemia, cardiac dysrhythmias, seizures, and comas.

Seizures 245

Seizures Pediatrics CDC Infectious Diseases 245

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. In a metropolitan area, pediatric patients with severe TBI should be transported directly to a pediatric trauma center if available.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation Pediatrics 98

The Skeptics' Guide to EM

DECEMBER 7, 2019

Pediatrics 2019 Guest Skeptic: Dr. Katie Noorbakhsh is a pediatric emergency physician at the Children’s Hospital of Pittsburgh. This is an SGEM Xtra and it was inspired by the recent publication in Pediatrics on BRUEs. […] The post SGEM Xtra: Strange BRUE first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

SheMD

JULY 6, 2023

When you attend 7-8 clerkships simultaneously, you can’t check off pediatrics and forget the immunization schedule ever existed! Picture this: you discover your neurology preceptor is studying seizure disorders in children, and you happen to be interested in pediatrics.

Ultrasounds 52

Ultrasounds Research Pediatrics Seizures 52

Pediatric Education

MARCH 3, 2024

Eclampsia is a severe complication of pre-eclampsia that has new onset seizures. D’Alessandro, MD Professor of Pediatrics, University of Iowa .” Estimate are between 1 – 5.6% of pregnancies have pre-eclampsia. Pre-eclampsia classification is based on symptoms. J Med Life. 2022;15(12):1488-1492. Pre-eclampsia.

Wellness 40

Wellness Pediatrics Seizures Stroke 40

Pediatric EM Morsels

MAY 10, 2024

Add the risk assessment for sudden cardiac death into your workflow Have you ever fainted or had a seizure without warning, during exercise or in response to a loud noise? Regional implementation of a pediatric cardiology chest pain guideline using SCAMPs methodology. Pediatrics. Pediatrics. Pediatr Clin North Am.

EKG/ECG 203

EKG/ECG Pediatrics Ultrasounds Seizures 203