PEMBlog

SEPTEMBER 13, 2023

Team members and families eagerly await your intervention to halt the seizure and understand its underlying cause. The lack of utility of laboratory testing in children with an unprovoked generalized seizure, or a simple febrile seizure is supported by several observational studies.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Emergency Medicine Cases

NOVEMBER 19, 2019

What is the essential list of immediate life threats with specific antidotes that we must know for the ED patient with a seizure? What are the key elements for distinguishing a true seizure from syncope? From Psychogenic Non-Epileptic Seizure (PNES)? Which patients who present with seizure require a CT head in the ED?

Seizures 52

Seizures Stroke EMS 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

Emergency Medicine Cases

JUNE 19, 2018

What management recommendations would you make to the rural ED physician, the transport team and in your ED with regards to treatment of seizures, safe correction of hyponatremia, airway management, search for underlying cause and prevention of Osmotic Demyelenation Syndrome?

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Seizures Ambulance Services Airway Management EMS 52

Science Based Medicine

MAY 8, 2024

Remember back in 1997, the Pokemon seizure episode? Hundreds of children reported symptoms, including seizures, after watching a specific episode of the Pokemon cartoon that includes a sequence of flashing alternating red and blue lights.

Seizures 52

Seizures 52

JournalFeed

DECEMBER 11, 2021

We cover patient-centered diagnostic excellence, alteplase before endovascular stroke treatment, steroids for pediatric retropharyngeal abscess, LP for febrile seizure, and the new AHA chest pain guideline. It’s the JournalFeed Podcast for the week of December 6-10, 2021.

Seizures 52

Seizures Stroke Pediatrics 52

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

The Skeptics' Guide to EM

DECEMBER 15, 2018

Acetaminophen and febrile seizure recurrences during the same fever episode. 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. Pediatrics.

Seizures 52

Seizures Pediatrics Emergency Department Outcomes 52

JournalFeed

AUGUST 7, 2021

We cover GRACE-1, communicating stats better, managing seizures after initial control, POCUS for intussusception, and reading STEMI on ECG with a paced rhythm. It’s the JournalFeed Podcast for the week of August 2-6, 2021.

Seizures 40

Seizures EKG/ECG 40

PulmCCM

JANUARY 29, 2024

EEG Advised, to Rule Out Nonconvulsive Seizures Nonconvulsive seizures are occasionally present in comatose patients after cardiac arrest, undetectable without testing. Seizure prophylaxis was advised against, as there is no evidence for its efficacy.

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CPR Seizures Documentation/Coding Shock 115

EMDocs

JANUARY 8, 2024

Avoid routine seizure prophylaxis in adult survivors of cardiac arrest (Level 3: no benefit), but treat seizures if they occur (Level 1: strong). Seizure and other epileptiform activity We recommend treatment of clinically apparent seizures in adult survivors of cardiac arrest. o C recommended (Level 1: strong).

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Seizures Shock CPR Hyperthermia / Hypothermia 78

Emergency Medicine Ireland

APRIL 29, 2024

They have a seizure on arrival and a Na comes back at 105. In this scenario they are seizing because of the low Na and rapid increase of the Na is needed to stop the seizure. A seizure seems fairly easy to define but “coma” is a little bit more vague. They have a seizure on arrival and a Na comes back at 105.

Seizures 75

Seizures Sepsis Stroke Administration 75

EMDocs

MAY 25, 2023

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 Editor Note: The key to status epilepticus is to stop the seizure.

Seizures 61

Seizures Administration Outcomes Anaphylaxis 61

EMDocs

JANUARY 11, 2024

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. EEG Monitoring and Seizures Statements Takeaway: If possible, obtain an EEG to evaluate for seizure activity.

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Seizures Shock Infectious Diseases CPR 71

RebelEM

JULY 26, 2023

Adenosine antagonism may lead to seizures and/or supraventricular tachycardia that is unresponsive to pushes of adenosine. Hemodialysis should also be considered in cases of refractory shock, dysrhythmias, or seizures. Eldridge 1989) Thus adenosine antagonism may lead seizures and/or status epilepticus. Exp Neurol. Read more

Seizures 82

Seizures COPD Shock EMS 82

Taming the SRU

AUGUST 25, 2023

to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1

Seizures 66

Seizures Fractures EKG/ECG Resuscitation 66

Dr. Smith's ECG Blog

OCTOBER 7, 2019

This is by one of our outstanding 3rd year residents , Aaron Robinson, with some edits and comments by Smith EMS responded to a reported seizure in a 42 year old male. He reports no personal or familial history of seizures. The physicians quickly recognized that this was not a seizure and likely cardiac in nature.

Seizures 52

Seizures EKG/ECG Shock EMS 52

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

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. On ED arrival GCS is 3, there are rapid eye movements to the right but no other apparent seizure activity. Check glucose, obtain imaging, stop the seizure. They administer two doses of 10 mg midazolam IM.

Seizures 70

Seizures Documentation/Coding EKG/ECG Emergency Department 70

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.

EKG/ECG 114

EKG/ECG Seizures Stroke EMS 114

EMDocs

APRIL 10, 2024

She reportedly received a landmark guided peripheral nerve block with bupivacaine and shortly thereafter developed generalized seizures. 1,5] CNS symptoms include: Seizure, coma, altered mental status. [1] 2,9] Benzodiazepines are the first line treatment for seizures. How do we manage patients in LAST? mL/kg/min. [2]

Advances Cardiac Life Support (ACLS) 89

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 89

Mind The Bleep

OCTOBER 20, 2023

They can cause a wide array of symptoms, such as seizures, weakness and dizziness, and typically there are clinical features that actively support the diagnosis of FND. Symptoms of FND -Functional seizures (also can be termed dissociative) -Motor symptoms (e.g. Some have high specificity (positive Hoover’s sign) but low sensitivity.

Seizures 52

Seizures Psychiatric 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

EMergucate

SEPTEMBER 14, 2022

A 64 year old male presents to ED after multiple seizure episodes that day. It was reported that the patient would have 20 seconds of seizure activity and then make a full recovering. The patient h…

Seizures 52

Seizures EKG/ECG 52

PEMBlog

AUGUST 28, 2023

Do not order laboratory testing or a CT scan of the head for a pediatric patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status.

Pediatrics 52

Pediatrics Seizures Psychiatric 52

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. Otherwise she was described as a normally developing child. How is pediatric stroke different than perinatal stroke?

Stroke 52

Stroke Seizures Pediatrics Hyperthermia / Hypothermia 52

EMDocs

JULY 3, 2023

4 Common symptoms of SAH on presentation include vomiting, neck stiffness, altered mental status or decreased level of consciousness, hemiparesis, and seizure-like activity. 18 Seizure Seizure is common in the setting of acute SAH, especially spontaneous SAH, due to cerebral and meningeal irritation. Neurocrit Care.

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Seizures Stroke Outcomes EMS 81

ECG Guru

AUGUST 2, 2023

His brother was diagnosed epilepsy and died during a seizure at the age of 21. This patient is a 50-year-old man. Parts of the following text i have taken over from Dawn`s explanation on Brugada pattern/Brugada syndrome:

Seizures 52

Seizures 52

Don't Forget the Bubbles

OCTOBER 23, 2023

They may also already have other seizure types and be under paediatric services. Maintenance therapy is sometimes required in patients with higher seizure risks. About 60% of infants develop other seizure types, including resistant epilepsy and Lennox Gastaut Syndrome. How are Infantile Spasms diagnosed?

Seizures 75

Seizures Outcomes Wellness 75

Board Bombs

APRIL 2, 2023

What if we told you there was a type of stroke that affected young people, caused more seizures than "typical arterial strokes", and the typical ED imaging does not diagnose it. Scared yet? You should be. Want to experience the greatest in board studying? Episode 171. Cerebral Venous Thrombosis: Sneaky Stroke. link] April 3nd, 2023.

Stroke 52

Stroke Seizures 52

Taming the SRU

FEBRUARY 5, 2024

As may be seen in the table below, there are several themes as well a range of stringency. Find the posterior superior iliac crest and draw an imaginary line across the back (Tuffier’s line) – where this line crosses midline is the L4 spinous process.

Infectious Diseases 86

Infectious Diseases Seizures Ultrasounds Sepsis 86

RebelEM

SEPTEMBER 27, 2023

If QRS >100 msec = 33% chance of seizures If QRS >160 msec = 50% of ventricular dysrhythmias Often extrapolated to other sodium channel blocking agents: diphenhydramine, loperamide, cocaine, lamotrigine, Type 1A/1C Anti-Dysrhythmics. As a result, it is essential to replete potassium simultaneously. N Engl J Med. PMID: 4022081.

Poisoning 87

Poisoning Seizures Administration EKG/ECG 87

EMDocs

MARCH 2, 2024

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]  2022 Mar;18(2):253-255. Palacios-García JM, Vazquez-Becerra E, Ropero-Romero F.  J Int Adv Otol. 2020

EMS 111

EMS Fractures Seizures Head Injuries 111

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 90

Poisoning Hyperthermia / Hypothermia Seizures Administration 90

EMergucate

JULY 16, 2012

Your next patient was witnessed to have a tonico-clonic seizure 30 min ago. Causes of persisting altered mental state following a seizure – status epilept… He remains GCS 6. Why might that be?

Seizures 40

Seizures 40

Dr. Smith's ECG Blog

MARCH 11, 2012

A young man presented after a prolonged seizure. He had had a fight with his girlfriend, and she thinks he ingested something, thinks it was ecstasy (MDMA) but might have been other things. The patient was unconscious. He was intubated. He had a combined respiratory and metabolic acidosis, with pH 6.98, pCO2 of 65 and HCO3 of 15.

Seizures 52

Seizures Shock EKG/ECG Outcomes 52

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