ALiEM

DECEMBER 4, 2023

Penile calciphylaxis is a rare finding that often portends a poor prognosis with a high mortality rate. References Nunley JR. Calcinosis cutis. link] Vedvyas, C., Winterfield, L. S., & Vleugels, R. Calciphylaxis: a systematic review of existing and emerging therapies. Journal of the American Academy of Dermatology, 67(6), e253–e260.

Academics 60

Academics Seizures Hospitals Emergency Department 60

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neuroscience and Biobehavioral Reviews. 2005; 29: 493–500. Panebianco M, Rigby A,Weston J,Marson AG. Cochrane Database of Systematic Reviews. 2015; 4, Art. J Amer Coll Cardiol.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Taming the SRU

MARCH 14, 2023

Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. The seizure abated with rectal diazepam given by the squad. You notice a med-alert bracelet with the patient’s name and the word “SEIZURES.” His abdomen is soft. Neuroradiology. Amer J Rad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

FEBRUARY 5, 2024

Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2]. 2012 Jan 15;85(2):123-32. In patients with an abnormal CT Head, decisions regarding management and disposition should be made in conjunction with a Neurosurgeon. JAMA Pediatr. 2021;175(11):1124–1131.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Taming the SRU

MARCH 31, 2023

Charon, Academic Med 2012) embracing fear in emergency medicine WITH dr. arlene chung What is fear? Narratives trigger changes of many kinds in both the teller and the listener, yielding meanings that are reciprocally produced by each teller-listener dyad.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Downeast Emergency Medicine

APRIL 26, 2021

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2017

The Systemic Lupus International Collaborating Clinics (SLICC) revised the criteria in 2012. The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI. 2012; AID 471759. 2012; 7:19796.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2016

S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. 2012; 33:1040–1045. ACCF 2012 Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations. 2012; 60(23): 2427-2463. 2012; 19:1276–1280. 2014; 14:83.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

MAY 1, 2017

Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. 2012; 129(4). 2012 Aug;130(2):e352-7. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Check the bilirubin in any neonate you are working up for sepsis. J Clin Neonatol. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. 2012 Jul-Aug;8(4):237-41. Right Dose – Dosing with IN meds will vary considerably from the IV route. Rule of thumb: the IN dose is 2-3 times the IV dose. J Opioid Manag.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Don't Forget the Bubbles

JULY 26, 2023

Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. The majority of the inherited rhythm disorders are autosomal dominant but their diagnosis relies on an electrically active heart.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

EMDocs

JULY 3, 2023

4 Common symptoms of SAH on presentation include vomiting, neck stiffness, altered mental status or decreased level of consciousness, hemiparesis, and seizure-like activity. 18 Seizure Seizure is common in the setting of acute SAH, especially spontaneous SAH, due to cerebral and meningeal irritation.

Seizures 98

Seizures Stroke Outcomes EMS 98

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

EMDocs

OCTOBER 5, 2024

4 The incidence of ESBL-E identified in bacterial cultures in the United States increased by 53% from 2012 to 2017. Imipenem confers highest risk of seizures ESBL-E are often hospital acquired infections and can prolong hospital stay or lead to worse outcomes. Increased incidence is largely due to increasing community spread.

EMS 93

EMS Infectious Diseases Sepsis Hospitals 93

EB Medicine

AUGUST 1, 2018

Jeff: Medicinally, cannabinoids are currently used in the treatment of chronic pain syndromes, complications of multiple sclerosis and paraplegia, weight loss due to appetite suppression in HIV/aids, chemotherapy-induced nausea and vomiting, seizures, and many other neuropsychiatric disorders.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Downeast Emergency Medicine

MARCH 24, 2021

Incubation typically 2-5 days, with illness lasting up to 10 days Association with Guillain-Barre syndrome Shigella Raw and unwashed vegetables Most common to get passed around daycare Seizures, AMS, coma Rectal prolapse possible from excessive diarrhea Fecal shedding E. Clin Infect Dis 2012, 55(7):897-904. Pubmed ]

Pediatrics 52

Pediatrics Dehydration Emergency Department Wellness 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

J Electrocardiology 45 (2012):433-442. Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Bayes de Luna, A et al. Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

EB Medicine

FEBRUARY 1, 2019

Nachi: Unfortunately, the 2008 ACEP guideline and 2012 AHA guidelines still recommend a lumbar puncture in those being worked up for SAH. Seizures are very common as well. That’s quite a list. For a visual reference, see Table 3 in the print issue. In addition, one 2016 study demonstrated a LR of 0.01

Emergency Department 40

Emergency Department Stroke Ultrasounds Outcomes 40

Dr. Smith's ECG Blog

JANUARY 21, 2023

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. Europace 2012 Shinde R, Shinde S, Makhale C, Grant P, Sathe S, Durairaj M, Lokhandwala Y, Di Diego J, Antzelevitch C. Seizure activity was witnessed in the ED.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

EMDocs

NOVEMBER 13, 2023

Lancet Neurol 2012, 11 (4), 307-314. J Trauma Acute Care Surg 2012, 72 (2), 330-335; discussion 336-337, quiz 539. Arch Neurol 2012, 69 (3), 346-351. CTA head/neck is absolutely indicated if suspicion is high for this condition. 46 All of these states are some gradation of consciousness impairment. 21) Romero, J. Artunduaga, M.;

Stroke 103

Stroke Radiology Radiology Emergency Department 103

EMDocs

JULY 19, 2023

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. Mercury levels in commercial fish and shellfish (1990-2012). Resources: S. Food and Drug Administration. 2022, February 25).

Poisoning 84

Poisoning Fluid Resuscitation Administration Seizures 84

Pediatric EM Morsels

MARCH 7, 2025

2012 Feb;147(2):113-9. of IV form TXA [O’Neill 2020] Inexpensive ! 2011 Mar26;377(9771):1096-101, 1101.e1-2. PubMed: 21439633] Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. Military Application of Tranexamic Acid in TraumaEmergency Resuscitation (MATTERs) Study. PubMed: 22006852] Nishijima DK, VanBuren JM, Linakis SW, et al.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

Don't Forget the Bubbles

FEBRUARY 24, 2025

We know that vaccination is key for protection, as there were 63 deaths in just one year before the vaccination was recommended in pregnancy in 2012. Infants usually present in a non-specific manner, following an apnoea, cough, cyanosis, or seizure so a high index of suspicion is required in this age group. Pediatr Crit Care Med J.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

In my experience CNS catastrophes ( not only SAH or other CNS bleeds but brain tumor trauma seizures coma from other cause ) may cause some of the most bizarre-appearing ECGs. Smith Cardiac cath was negative and today's unfortunate patient succumbed from her devastating SAH ( S ub A rachnoid H emorrhage ).

EKG/ECG 92

EKG/ECG Resuscitation EMS Seizures 92

Taming the SRU

JANUARY 5, 2025

Potential complications include dysrhythmias, respiratory failure, DIC, seizures, and hepatic failure. Ann Clin Psychiatry 2012; 24:310318. mg/kg initially followed by 1mg/kg q6hrs Disposition NMS can be very severe and usually requires ICU level care. Workup for complications should be initiated on a case by case basis.

Hyperthermia / Hypothermia 97

Hyperthermia / Hypothermia Dehydration Psychiatric Poisoning 97

Don't Forget the Bubbles

OCTOBER 9, 2023

A 13-year-old girl came to the ED with an unprecedented, prolonged seizure. When she arrived in the department, the seizure had stopped. 2012) Building Empowering Work Environments That Foster Civility And Organizational Trust: Testing an Intervention. A head CT scan was arranged. K, Leiter M. P, Day A, Gilin-Oore D.

Seizures 116

Seizures Incident Reporting Emergency Department Research 116

EMDocs

NOVEMBER 2, 2024

bladder incontinence) – 17% Headache – 10% Lighting pains – 10% Often described as sudden, rapidly spreading and disappearing [13] Dizziness – 10% Hearing loss – 10% Seizures – 7% Signs: Hyporeflexia – 50% Sensory impairment (e.g., Sexually transmitted diseases 39,6 (2012): 453-7. Symptoms: Personality change (i.e., doi:10.1097/OLQ.0b013e31824b1cde

EMS 111

EMS Infectious Diseases CDC Research 111