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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., Tunkel, A. Hartman, B. Kaplan, S.

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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

However, other sources suggest that the optimal blood pressure target is not well established and may vary depending on the individual patient’s characteristics and the type of hemorrhagic transformation [7]. 2004 Feb;35(2):520-6. Epub 2004 Jan 15. 2004 Jun;35(6):1364-7. Epub 2004 Apr 29. Castillo J, et al.

Stroke 73
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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

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. Indian Pacing Electrophysiol J 2004 Antzelevitch C, Yan G. 2004 = My Comment by K EN G RAUER, MD ( 1/21 /2023 ): = I thought today's case by Drs.

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A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

A New Seizure in a Healthy 20-something More cases of long QT not measured correctly by computer (these are all fascinating ECGs/cases): Bupropion Overdose Followed by Cardiac Arrest and, Later, ST Elevation. Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest.

EKG/ECG 115
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The Undifferentiated Sick Infant

Pediatric Emergency Playbook

Perhaps diGeorge syndrome with hypocalcemia and seizures? Inborn Errors of Metabolism - there are over 200 inborn errors of metabolism, but only four common metabolic pathways that cause a child to be critically ill. Philadelphia, PA, Lipincott Williams & Wilkins, 2004. Newborn Emergencies: The First 30 Days of Life.

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Pediatric Headache: Some Relief for All

Pediatric Emergency Playbook

The American Academy of Neurology's most recent guidelines, published first in 1994 and revised in 2004. Headache plus… a new seizure. An eleven-year-old girl presents to the ED with new headache, nausea, and vomting in the morning, then had a generalized seizure later that day, and presents with a low GCS. Pediatrics.

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MI in Children

Pediatric Emergency Playbook

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.