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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). WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., As may be seen in the table below, there are several themes as well a range of stringency.

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Sickle Cell Disease Module

Don't Forget the Bubbles

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. Do not use pethidine since it can cause seizures and CNS hyperexcitability. What is the role of transcranial dopplers in primary prevention of strokes?

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Pediatric Status Epilepticus

Pediatric Emergency Playbook

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.) During a seizure, GABA receptors in the neuron’s membrane are internalized and destroyed.

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The Higher Tech Kid in the ED

Pediatric Emergency Playbook

Also used for severe MS, stroke, TBI, chronic pain. Vagus nerve stimulation for partial seizures. 2010; 30:76–81. 2010; 6: 46-53. Are VNS safe in everyday life? Intrathecal Pumps Used to infuse basal rate of drug, usually baclofen for spasticity, but pump may contain morphine, bupivicaine, clonidine. 2005; 29: 493–500.

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Podcast Episode: Febrile Seizures

PEMBlog

Febrile Seizures are among the most common neurological problema in young children, occurring in 1 out of 50 children between the ages of 6 months and 5 years of age. Febrile Seizure. Common variants associated with general and MMR vaccine-related febrile seizures. Updated 2024 Jan 19]. In: StatPearls [Internet]. Ann Emerg Med.

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Altered Mental Status in Children

Pediatric Emergency Playbook

For altered adults, use AEIOU TIPS (Alcohol-Epilepsy-Insulin-Overdose-Uremia-Trauma-Infection-Psychosis-Stroke). sludge phenomenon, secondary sepsis, hypoglycemia from supply-demand mismatch) S – Seizure (e.g. sludge phenomenon, secondary sepsis, hypoglycemia from supply-demand mismatch) S – Seizure (e.g. V – Vascular (e.g.

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Grand Rounds Recap 3.15.23

Taming the SRU

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.