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Complications of Kratom Use

Northwestern EM Blog

Written by: Dean Hayes (NUEM 27) Edited by: Andrew Long (NUEM 25 ) Expert Commentary by: Rafael Lima, MD A mid 20s male presents to the ED after seizure-like activity. Per the patient's partner at bedside, he had a 2-3 minute convulsive episode and the description is consistent with a likely seizure. and Can Kratom cause seizures?

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Chest Pain in Children: ReBaked Morsel

Pediatric EM Morsels

Add the risk assessment for sudden cardiac death into your workflow Have you ever fainted or had a seizure without warning, during exercise or in response to a loud noise? 2011 Aug;128(2):239-45. Have you ever had chest pain or shortness of breath in exercise? Has anyone in the family died unexpectedly before age 50? Pediatrics.

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ToxCard: Iron

EMDocs

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Consider intubation for patients with airway compromise, respiratory failure, altered mental status, or seizure. 5 Seizure: IV benzodiazepine first line, barbiturates as second line.

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Cannabidiol in refractory status epilepticus

Don't Forget the Bubbles

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
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Super Refractory Status Epilepticus

Don't Forget the Bubbles

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 111
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ToxCard: Bupropion

EMDocs

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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ToxCard: N-Acetylcysteine for Acetaminophen Toxicity

EMDocs

Massive acetylcysteine overdose associated with cerebral edema and seizures. 2011 Jun;49(5):423-5. In vitro analysis of N-Acetylcysteine (NAC) interference with the International Normalized Ratio (INR). Clinical Toxicology , 60 (4), 489–492. link] Heard K, Schaeffer TH. Clin Toxicol (Phila). doi: 10.3109/15563650.2011.583664.