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52 in 52 – #36: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus

EMDocs

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 mg/kg or 10 mg Intravenous lorazepam 0.1

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EM@3AM: Pneumocephalus

EMDocs

A) Administration of mannitol B) Admission for observation C) Discharge home D) Discharge home with oral steroids Answer: B The patient has a skull fracture with an overlying laceration. Administration of mannitol (A) is indicated for patients with elevated intracranial pressure. 2015 Sep 29;6:155.  Korean J Anesthesiol. 2010

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emDOCs Revamp: Esophageal Perforation

EMDocs

1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). PPI administration to decrease gastric acid secretion. 5 Consider antifungal administration. Am J Emerg Med.

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Toxic Alcohols

Northwestern EM Blog

Clinical Findings of Methanol Poisoning CNS sedation Seizures Rapid, Deep Breathing Hypotension Ocular findings: Blindness Afferent pupillary defect Optic disk hyperemia Mydriasis Ethylene Glycol Toxicity Similarly, the toxic metabolites of ethylene glycol cause end-organ damage at levels greater than 20mg/dl. Clin Toxicol (Phila), 2015.

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Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

First described in 1970, RSI with the near-simultaneous administration of a sedative agent and NMBA has been shown to have increased first-pass success compared with intubation facilitated by a sedative alone (6,7). Contraindicated seizures or porphyria. WJEM 2015; 16(7): 1109 – 17. 2015 Dec;30(8):499-504. Am J Emerg Med.

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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.

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Episode 19 - Cannabinoids: Emerging Evidence in Use and Abuse

EB Medicine

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.