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Choosing Wisely – Investigations for seizures that have returned to baseline

Don't Forget the Bubbles

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
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You don’t need labs or CT scans in children who have recovered after a simple febrile or first time seizure

PEMBlog

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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But Can You Just PO?

Taming the SRU

Preparation requires: One liter of safe water Half a small spoon of salt (3.5 This has been particularly validated in pediatric literature; however, this can be applicable to the adult patient population within the right circumstances i.e ability to protect airway and the lack of clinical findings suggesting a need for IV fluid resuscitation.

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Altered Mental Status in Children

Pediatric Emergency Playbook

sludge phenomenon, secondary sepsis, hypoglycemia from supply-demand mismatch) S – Seizure (e.g. Many authors report a broad array of neurological manifestations associated with influenza, such as altered mental status, seizures, cranial nerve abnormalities, hallucinations, abnormal behavior, and persistent irritability.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

National Acute Chest Syndrome Study Group [published correction appears in N Engl J Med 2000 Sep 14;343(11):824]. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia. Vichinsky EP, Neumayr LD, Earles AN, et al.

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Case Report: Toxic Hypoglycemic Syndrome

ACEP Now

1 In severe cases altered mental status, seizures, coma, or even death have been observed. Due to concerns regarding THS, the import of ackee fruit was outlawed in 1972, but since 2000 canned exports have been allowed by certain “green listed” manufacturers by the Federal Drug Administration. Am J Trop Med Hyg. 2015;93(5):1122–3.

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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This document is an update of guidelines first published in 2000, and then updated in 2007. 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.