Taming the SRU

FEBRUARY 5, 2024

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., Clin Infect Dis. 2018;66(3):321-328.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

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

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

EMDocs

JANUARY 29, 2024

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]. 2013 Jul;44(7):1846-51. Epub 2013 May 23. This includes intraparenchymal hemorrhage and subarachnoid hemorrhage (SAH).

Stroke 99

Stroke Outcomes EMS Seizures 99

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. Most of the definition is in the name itself. * The name was not reassuring and the definition was vague.

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. 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. Capriola, M.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

EMDocs

SEPTEMBER 25, 2023

They increase the risks of hypoxia and acidosis during the apneic period as well as hypotension and hypoperfusion caused by the abrupt transition from negative-pressure to positive-pressure ventilation (10). Contraindicated seizures or porphyria. Resuscitation 2013; 84(11): 1500 – 4. 2013): 71-78. Pain upon injection.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

Pediatric Emergency Playbook

JUNE 1, 2017

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.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

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

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients. J Am Coll Cardiol.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 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, 2017

Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

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. " Well, then, what to do? 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. Erickson, M.D. (an Hypnotherapy.

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 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 They are found in large numbers in the mouth, throat, and stomach, as well as throughout the body. A habanero pepper. million Scoville units.

Burns 40

Burns Poisoning Seizures Stroke 40

PEMBlog

OCTOBER 2, 2024

2013-0421 Tighe M, Afzal NA, Bevan A, et al. Children with respiratory conditions and chronic lung disease like asthma are more prone to GERD as well. This is sometimes misidentified as seizures. So, the parents may say, well, he Doesn’t ever seem full. Well, baby doesn’t know how to be full.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

ACEP Now

MARCH 11, 2025

16 An elevated amylase suggests repetitive vomiting as well. Serum phosphate should be obtained in all patients with eating disorders as hypophosphatemia is suggestive of refeeding syndrome, which can be fatal. 16 Refeeding syndrome occurs when feeding is started after a period of prolonged deprivation. Int J Eat Disorder., Int J Eat Disord.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

ALiEM

MARCH 5, 2024

Cases of toxicity have been reported following ingestion of supplements as well as ingestion of willow bark tea [4,5]. With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. 2013 May;5(5):330. Willow tree bark supplements are available as tablets, tinctures, powders, or tea.

Hyperthermia / Hypothermia 114

Hyperthermia / Hypothermia Anaphylaxis Poisoning Administration 114

EMDocs

JUNE 14, 2023

This leads to an enhanced, as well as a prolonged predominant cholinergic effect. Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Published 2013 Dec 9. Farmers treating sheep for parasites may be symptomatic after exposure, an illness called Dipper’s Flu. BMC Res Notes. 2013;6:524.

PPE 95

PPE Poisoning Seizures Emergency Department 95

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. Am Surg 2013, 79 (1), 23-29. Eur Radiol 2013, 23 (6), 1443-1449. 8 The data in Mayer et al.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Don't Forget the Bubbles

FEBRUARY 24, 2025

They were a well-grown, term infant born in good condition. Since the introduction of the Pertussis vaccination in pregnancy, from 2013 to the end of October 2024, there have been 31 deaths in infants under 3 months with confirmed Pertussis (eleven of which occurred in 2025). Sounding familiar? Ann Intensive Care.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

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

NOVEMBER 2, 2024

The CSF studies return positive for CSF VDRL as well as for CSFfluorescent treponemal antibody-absorption test (FTA-ABS), with 75 WBCs/microL and a CSF protein of 60 mg/dL and elevated opening pressures. 2013 Dec;51(12):4060-6. Cerebrospinal fluid (CSF) studies are obtained in the recumbent position for opening pressures.

EMS 115

EMS Infectious Diseases CDC Research 115