ALiEM

MARCH 5, 2024

With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. 2013 May;5(5):330. Salicylate has a direct effect on the respiratory center of the medulla causing tachypnea. Tinnitus, nausea, vomiting, and abdominal pain are common. Phytotherapy Research. 2015;29(8):1112-1116. PMID: 25997859.

Hyperthermia / Hypothermia 114

Hyperthermia / Hypothermia Anaphylaxis Administration Poisoning 114

EMDocs

JUNE 7, 2023

Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Case Follow-up: The patient required benzodiazepine administration for seizure management and subsequent intubation for airway protection. 2013; 6:524. Published 2013 Dec 9. Clin Toxicol (Phila) 51: 838, 2013. 8 Figure 1.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

Taming the SRU

FEBRUARY 5, 2024

As may be seen in the table below, there are several themes as well a range of stringency. Find the posterior superior iliac crest and draw an imaginary line across the back (Tuffier’s line) – where this line crosses midline is the L4 spinous process. Clin Infect Dis. 2018;66(3):321-328. doi:10.1093/cid/cix806 5. Glimåker, M., Johansson, B.,

Infectious Diseases 96

Infectious Diseases Seizures Ultrasounds Sepsis 96

Cook County EM Blog

MAY 29, 2023

Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. If a therapeutic dose is chewed, it can lead to bronchospasm, laryngospasm, seizures, and cardiovascular collapse which further reinforces the danger to children.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Don't Forget the Bubbles

JUNE 30, 2023

CRASH 2 , published in 2013 – was huge. As in CRASH-2, TXA did not show a significant increase in thrombotic events or seizures. There was a small increased risk of seizures in the TXA group – 0.3% (7 children) of the 1900 children in the TXA group vs none of the 1900 children in the non-TXA group. This is not good.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

EMDocs

JUNE 14, 2023

Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Published 2013 Dec 9. doi:10.1186/1756-0500-6-524 Ross SM, McManus IC, Harrison V, Mason O: Neurobehavioral problems following low-level exposure to organophosphate pesticides: a systematic and meta-analytic Crit Rev Toxicol 43: 21, 2013.

PPE 69

PPE Poisoning Seizures Emergency Department 69

ALiEM

NOVEMBER 15, 2023

1,6,7] Dizziness, confusion, headache Shortness of breath Weakness and malaise Nausea and vomiting Hypotension, seizures, coma, apnea, arrhythmias Death due to cardiorespiratory arrest How do you diagnose cyanide poisoning? [7] 2013 ;2013:610648. What are the symptoms of cyanide poisoning? ISRN Toxicol. Ann Emerg Med.

Poisoning 67

Poisoning Pediatrics Seizures Administration 67

PEMBlog

MAY 9, 2024

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.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 66

Sepsis Shock Resuscitation Fluid Resuscitation 66

Pediatric EM Morsels

AUGUST 18, 2023

Myth # 2: Neurologic affects Nervous system adverse events mostly include central concerns (ex, seizures, headaches, dizziness, lightheadedness, sleep disorders, hallucinations) and peripheral neuropathy. So, in the right clinical situtation, the benefits of the fluoroquinolone use in children may outweigh the risk.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Don't Forget the Bubbles

MARCH 18, 2024

A similar process can also occur in the CNS (causing seizures ), the liver and the pancreas. Depending on the progression of the illness, children may present with pallor, oedema, lethargy, seizures, hypertension or abnormal liver function tests. Red blood cells break down in the capillaries, leading to anaemia. What is atypical HUS?

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Mind The Bleep

OCTOBER 29, 2024

These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. 2013 May;74(5):1363-6. However, if PEG is not immediately available, irrigation with water can be initiated. Phenol exposure can lead to significant skin damage and systemic effects.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. 2013; 49:138–144. 2013; 29:347–349. 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. 2015; 4, Art. Pediatr Neurosurg.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

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.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

The Skeptics' Guide to EM

DECEMBER 7, 2019

The Journal of Pediatrics published a systematic review of literature regarding the Management of ALTE in 2013 and one of the findings was that there was very little agreement in the literature on how to apply the definition. The diagnosis could have caused a great deal of anxiety in parents/caregivers.

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

ACEP Now

DECEMBER 10, 2023

Although cases of human milkweed exposure are rare, a 2013 case reported a 42-year-old man experiencing cardiac symptoms and nausea after consuming fried milkweed pods from a recipe he found online. In the ED, he was found to have a heart rate in the 40s, and a digoxin level of 1.0 ng/mL (cross reactivity of the assay) and a potassium of 4.2

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

Pediatric Emergency Playbook

MAY 1, 2016

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.

Seizures 40

Seizures Sepsis Stroke Pediatrics 40

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. 2013 Jul;44(7):1846-51. Epub 2013 May 23. doi: 10.1161/STROKEAHA.113.001212.

Stroke 72

Stroke Outcomes EMS Seizures 72

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

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. ACEP/McGraw-Hill, 2013. Philadelphia, PA, Lipincott Williams & Wilkins, 2004. McGowan et al. Circulation.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

HELLP Syndrome [pdf] Sara Paul MD Intrauterine Fetal Demise [ppt] Irene Hwang, MD Obesity in Pregnancy [pdf] Rafael Garabis, MD Seizures in Pregnancy [ppt] Sherifia Heron , MD Substance Abuse in Pregnancy [ppt] Sophia Y. Emergency medicine international, 2013. 2013) Trauma and Pregnancy. Episiotomy [ppt] Alice Teich, MD.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

ACEP Now

APRIL 2, 2024

Carolina Reaper, under whose effects I was suffering, is a cultivar of ( Capsicum chinense ) and was declared in 2013 to be the hottest chili pepper in the world with greater than 1.6 8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. A habanero pepper. million Scoville units.

Burns 40

Burns Poisoning Seizures Stroke 40

Pediatric Emergency Playbook

JUNE 1, 2017

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. 2013; 34(3):489-491. 2013; 34(4). 2013; 8(2):61-63. 2013; 6(5):752-761. World Journal for Pediatric Congenital Heart Surgery.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EMDocs

SEPTEMBER 25, 2023

Contraindicated seizures or porphyria. Resuscitation 2013; 84(11): 1500 – 4. 2013): 71-78. Minimal histamine release. Cons: Short duration of action. Pain upon injection. Adrenal suppression, limiting its use in long procedures or critically ill patients. Excellent amnestic and sedative properties. Can be titrated easily.

Emergency Department 65

Emergency Department Soft Tissue Injuries Operations Airway Management 65

Pediatric Emergency Playbook

APRIL 1, 2016

S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. Cardiology in the Young; 2013. 2013; 88(10): 1127–1140. 2013; 29:715-719. 2013; 14(8): e380–e387. Difficult to interpret lactates when a patient is on an epinephrine drip. J Am Coll Cardiol.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

ACEP Now

MAY 10, 2024

A 9-month-old male presents to emergency department (ED) with his mother for seizure. The child was diagnosed with seizure disorder at 2 months of age and has had multiple visits to the emergency department (ED) for seizures. The child was started on Levetiracetam and levels always have been normal despite breakthrough seizures.

Forensics 98

Forensics Psychiatric Seizures Pediatrics 98

Advanced Emergency Nursing from AENJ

NOVEMBER 7, 2015

Even as a Paramedic, in the early days, there was no analgesia, sedative (except for seizures), or anesthetic, to provide. Last reviewed on 9/19/2013. In the first part of my career, I did ambulance work, before there was ACLS, and certainly no pain medicine. We had only first aid, oxygen, and CPR to offer. PDF ] PMID: 11971825.

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

Pediatric Emergency Playbook

MAY 1, 2017

Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. 2013 Apr-Jun; 2(2): 61–69. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Check the bilirubin in any neonate you are working up for sepsis. Pediatrics. 2004; 114(1). Bhutani VK, Wong RJ.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

PEMBlog

OCTOBER 2, 2024

2013-0421 Tighe M, Afzal NA, Bevan A, et al. This is sometimes misidentified as seizures. J Pediatr Gastroenterol Nutr. 2018;66(3):516-554. doi: 10.1097/MPG.0000000000001889 0000000000001889 Lightdale JR, Gremse DA; Section on Gastroenterology, Hepatology, and Nutrition. Pediatrics. 2013;131(5):e1684-1695. doi: 10.1542/peds.2013-0421

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

ACEP Now

OCTOBER 29, 2024

3-6 Additional features include first-degree atrioventricular block, atrial arrhythmias, nocturnal agonal breathing, and seizures. Arrythmias are common during febrile illnesses and in sleep. Figures 4: A. Heart Rhythm. 2013;10(12):1932-1963. Pannone L, Bisignani A, Osei R, et al. Genetic Testing in Brugada Syndrome: A 30-Year Experience.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 52

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., 2013 Dec;51(12):4060-6. Symptoms: Personality change (i.e., J Clin Microbiol. Accessed July 19, 2024.

EMS 91

EMS Infectious Diseases CDC Research 91

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. 2013) Civility, Respect and Engagement at the Workplace (CREW): A National Organization Development Program at the Department of Veterans Affairs. A head CT scan was arranged. and Ramsel D.

Seizures 116

Seizures Incident Reporting Research Hospitals 116

EMDocs

NOVEMBER 13, 2023

Am Surg 2013, 79 (1), 23-29. Eur Radiol 2013, 23 (6), 1443-1449. Neurology 2013, 81 (11), 1004-1011. AJNR Am J Neuroradiol 2013, 34 (5), 1077-1081. Radiology 2013, 267 (1), 119-128. CTA head/neck is absolutely indicated if suspicion is high for this condition. Rotondo, M. Gracias, V. 34) Filler, L.; 37) Alons, I.

Stroke 86

Stroke Radiology Radiology Emergency Department 86