PEMBlog

SEPTEMBER 15, 2023

Did you know that lab tests and CT scans are not recommended for most children who fully recover after a simple febrile seizure or a first-time, unprovoked generalized seizure? This video features Dr. Archit Sahai who conducts a simulated discussion with a parent of a child following a seizure.

Seizures 52

Seizures Pediatrics 52

Emergency Medicine Journal

SEPTEMBER 27, 2023

Clinical introduction A middle-aged man is brought to your ED following a self-limiting generalised tonic–clonic seizure. He is a smoker, with a history of chronic obstructive pulmonary disease (COPD) and peripheral vascular disease, but no previous seizures. He is on aspirin and clopidogrel.

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Seizures COPD 40

Emergency Medicine Education

JULY 26, 2023

This is an observational study among patients presenting to 3 EDs with Seizure and they found approximately 12 % of patients had some neuroimaging findings! Link to the article

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Seizures 40

Pediatric EM Morsels

JULY 26, 2024

Treat the seizures , but…. Keep in mind that seizure management can be difficult and the patient may not respond to AEDs. May see non-specific white and gray matter changes. Pelvic and abdominal imaging to assess for tumor (see below) Anti-NMDA Receptor Encephalitis: Treatment Remember your ABCs! Serum AND CSF antibody titers!

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Seizures Psychiatric Outcomes Pediatrics 141

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.

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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

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.

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Seizures 120

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

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.

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Seizures Pediatrics Research Wellness 119

PEMBlog

JULY 8, 2024

Lyrics [Chorus] Benzo, Benzo, second line Seizures stop in record time! Verse] Seizures longer than five minutes straight Need medication to help them abate Lorazepam’s great if you have an I V I M drugs are fine too you’ll see [Chorus] Benzo, Benzo, second line Seizures stop in record time!

Seizures 52

Seizures Emergency Department 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

SEPTEMBER 7, 2019

She is also the […] The post SGEM#265: Total EcLiPSE of the Seizure – What a ConSEPT first appeared on The Skeptics Guide to Emergency Medicine. Case: Julia is a 4-year-old girl with a history of seizures and developmental delay. Our focus on management of status is to stop the seizures quickly to avoid any complications.

Seizures 52

Seizures Emergency Department Hospitals 52

Mount Sinai EM

AUGUST 20, 2023

If seizures , treat with usual benzodiazepines. Hypoxemia, hypercarbia and acidosis worsen the toxicity. Establish 2 IV access. Patient should already be on a monitor. If hypotension , give small doses of epinephrine (1 mcg/kg bolus). Avoid phenylephrine and vasopressin. Lorazepam 2-4 mg/IV or Midazolam 10 mg/IM.

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Seizures Shock Outcomes 243

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

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?

Seizures 108

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 108

Northwestern EM Blog

JULY 22, 2024

PRES can quickly devolve from a throbbing, atypical headache to seizures and brain hemorrhage, so intervening as soon as possible with aggressive BP reduction is the goal. Seizure management follows generally conventional practices. Adjunctive magnesium infusions are indicated for pregnant and postpartum cases.

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Seizures Documentation/Coding Hospitals 81

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

EMDocs

MAY 9, 2024

The triage nurse records the event as a “seizure” lasting 7 minutes. His MDM says nothing about the patient’s seizure but does state that “there is an ongoing community outbreak of gastroenteritis… and 6 patients currently in the ED with similar sx.” Plaintiff : You never acknowledged the alleged “7 minute” seizure.

Seizures 82

Seizures Dehydration Documentation/Coding Infectious Diseases 82

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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Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

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.

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Seizures Pediatrics CDC Infectious Diseases 240

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 82

EMDocs

JANUARY 4, 2024

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent.

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Seizures EKG/ECG Poisoning Shock 66

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.

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Seizures Administration Outcomes Anaphylaxis 63

Emergency Medicine News

MAY 16, 2024

An abstract is unavailable.

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Seizures 40

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 75

Ken Grauer, MD

MAY 31, 2024

Doing so will commonly show one or more electrode leads to be loose — OR — the patient to be shaking, trembling, shivering, having a seizure, scratching or other obvious cause of the bizarre deflections seen. PEARL # 2: The simple step of going to the bedside to LOOK at the patient will often be revealing.

Shock 400

Shock EKG/ECG Seizures 400

ACEP Now

MAY 10, 2024

A 9-month-old male presents to emergency department (ED) with his mother for seizure. The child was diagnosed with seizure disorder at 2 months of age and has had multiple visits to the emergency department (ED) for seizures. The child was started on Levetiracetam and levels always have been normal despite breakthrough seizures.

Forensics 98

Forensics Psychiatric Seizures Pediatrics 98

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

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Seizures COPD Shock EMS 85

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

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

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Seizures Fractures EKG/ECG Resuscitation 68

RebelEM

JULY 10, 2024

Red flags in patients with headaches that may suggest a brain tumor include signs of increased intracranial pressure, focal neurological signs, seizures or ataxia. Avoid sedation and lying supine and steroids in patients with mediastinal masses. Post Peer Reviewed By: Salim R.

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Seizures Administration EMS Wellness 59

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.

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Seizures Documentation/Coding EKG/ECG Emergency Department 72

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.

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Seizures Sepsis Stroke Administration 75

Emergency Medicine Cases

SEPTEMBER 12, 2023

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

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EKG/ECG Seizures Stroke EMS 115

Taming the SRU

SEPTEMBER 24, 2023

Patients with a history of seizures, supratentorial structural brain pathologies, post-arrest, or unexplained altered mental status should prompt suspicion for NCSE. However, Ceribell is a useful technology to help detect seizure activity and affect disposition. Two main theories behind the development of PRES. (1)

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Seizures EKG/ECG Emergency Department Shock 52

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