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]. 2015 Jun;11(2):227-31. 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

ALiEM

SEPTEMBER 27, 2023

Acute hepatitis Disulfiram-like reaction with ethanol consumption Pneumonitis from inhalation of spores Seizures from glutamate agonist activity [Image from Canstockphoto] Reveal the Answer 2. What well-known adverse reaction results from ingestion of the pictured mushroom? Encyclopedia of Toxicology (Third Edition), Academic Press.

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Seizures Academics Wellness 67

ALiEM

DECEMBER 4, 2023

2015 Jul;66(1):133-46. Epub 2015 May 7. link] Nigwekar SU, Kroshinsky D, Nazarian RM, Goverman J, Malhotra R, Jackson VA, Kamdar MM, Steele DJ, Thadhani RI. Calciphylaxis: risk factors, diagnosis, and treatment. Am J Kidney Dis. doi: 10.1053/j.ajkd.2015.01.034. 2015.01.034. PMID: 25960299; PMCID: PMC4696752.

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Academics Seizures Hospitals Emergency Department 60

EMDocs

NOVEMBER 1, 2023

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). McGraw-Hill Education; 2015. upper endoscopy, transesophageal echo, etc.). Am J Emerg Med. 2022;53:29-36.

Operations 95

Operations Radiology Radiology Fluid Resuscitation 95

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. 2015 Nov;46(5):586–9. 2015 Jul 4;30(12):2115–9. 2015 [cited 2024 Jan 19].

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. 2015; 4, Art. 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.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 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

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. Lancet Neurol.

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Seizures Emergency Department Pediatrics Critical Access 52

Northwestern EM Blog

MARCH 28, 2022

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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Poisoning Seizures Administration Pediatrics 52

EMDocs

SEPTEMBER 25, 2023

Contraindicated seizures or porphyria. WJEM 2015; 16(7): 1109 – 17. 2015 Dec;30(8):499-504. 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 93

Emergency Department Soft Tissue Injuries Airway Management Operations 93

Taming the SRU

MARCH 31, 2023

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.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 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. Asthma in Pregnancy [ppt] James Huang, MD Chorioamnionitis [ppt] Sara Paul M.D Episiotomy [ppt] Alice Teich, MD.

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OB/GYN Ultrasounds Emergency Department Resuscitation 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. 2015; 19(2):e107-e109. 2015; AID 953826. 2015; AID 905097. Pediatr Cardiol. 2013; 34(3):489-491. Liu Y, Miller BW. Case Reports Cardiol.

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Pediatrics EKG/ECG Wellness Seizures 52

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. 2015;313(24):2456-2473. Subst Abus.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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. 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.

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. 2015; 135(5):948-53. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Check the bilirubin in any neonate you are working up for sepsis. References Benitz WE. Pediatrics. Bhutani V et al.

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Dehydration Pediatrics Wellness Seizures 52

ACEP Now

APRIL 2, 2024

8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. March 13, 2015. 6 Inadvertent exposure to the eyes can result in severe pain, lacrimation, visual blurring, conjunctival injection, lid swelling; corneal injuries are possible. to recall the product. J Emerg Med. Chicago Tribune.

Burns 40

Burns Poisoning Seizures Stroke 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

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

This includes subdural hematomas, comas, paraplegia, quadriplegia, fractures and seizure disorders, regardless of the time interval between the injury and death. Published January 15, 2015. All cases known or suspected as coming under the jurisdiction of the Medical Examiner-Coroner should be reported immediately to (323) 343-0711.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Taming the SRU

FEBRUARY 22, 2023

HIV related renal disease HIV Associated Nephropathy (HIVAN) Form of FSGS Renal recovery can occur with ART Can occur prior to HIV seroconversion HIV Immune Complex Kidney Disease Less common than HIVAN Develops later in disease course Better prognosis Dermatologic Manigfestations of HIV HIV Associated Facial molluscum in an adult Proximal subungual (..)

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Hospice EKG/ECG Resuscitation Seizures 40

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. Neurocrit Care.

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Seizures Stroke Outcomes EMS 98

EMDocs

DECEMBER 16, 2023

As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. Clinical decision making in seizures and status epilepticus. 2015 Jan;17(1):1-24 Hostler D, Northington WE, Callaway CW. The patient is agitated, not oriented, and becoming combative with ED staff. 1 Fever is usually < 40C. link] Kakoki, K.,

Hyperthermia / Hypothermia 96

Hyperthermia / Hypothermia EMS Stroke Seizures 96

Dr. Smith's ECG Blog

APRIL 8, 2015

First: Are you sure it was syncope, and not SEIZURE? Conversely , frequently syncope has a short episode of tonic-clonic activity that mimics seizure. Patients with trauma, alcohol, or drug-associated loss of consciousness and definite seizures were excluded. 18) Venkatesh Thiruganasambandamoorthy et al.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2016

Headache plus… a new seizure. An eleven-year-old girl presents to the ED with new headache, nausea, and vomting in the morning, then had a generalized seizure later that day, and presents with a low GCS. 2015 Feb;135(2):232-8. 2015; 29(23) 1: 85-89. Headache plus… it’s unilateral and new for the patient. 2014; vol 2014.

Pediatrics 52

Pediatrics Emergency Department Seizures Wellness 52

EB Medicine

FEBRUARY 1, 2019

In addition, one 2015 study found that patients without xanthrochromia and less than 2000 RBC were effectively ruled out of having a SAH with a combined sensitivity of 100% Jeff: Lots of 100% sensitivities and specificities being thrown around today, which is definitely not the norm. Seizures are very common as well.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al.,

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

EMDocs

NOVEMBER 13, 2023

DOI: 10.1136/neurintsurg-2015-012131 From NLM. (10) Bmj 2015, 351 , h5762. Journal of the American College of Surgeons 2015, 220 (6), 1027-1031. Acta Neurol Scand 2015, 131 (3), 164-168. Stroke 2015, 46 (8), 2368-2400. CTA head/neck is absolutely indicated if suspicion is high for this condition. 10) Beume, L.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Pediatric EM Morsels

NOVEMBER 15, 2024

Seizures are super scary for a parent to witness, but not all seizures mean danger. There is actually a diagnosis of seizures that has “ BENIGN” in the name! We have even talked about using a ketogenic diet to control seizures , and seizure mimics.

Seizures 154

Seizures Stroke Pediatrics Wellness 154

Pediatric EM Morsels

OCTOBER 6, 2023

(Britto 2017) There have been several neurological complications associated with typhoid fever in pediatric patients (Britto 2017): It has an increased association with febrile seizures. Typhoid Fever in the US Pediatric Population, 1999-2015: Opportunities for Improvement. 2019 Jul;25(7):1082-1088. Clin Infect Dis.

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Pediatrics CDC Seizures Documentation/Coding 164

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. 2015, March 26). Symptoms include tremor, personality changes , emotional lability, gait disturbance , paresthesias, and ataxia.

Poisoning 94

Poisoning Fluid Resuscitation Administration Seizures 94

Don't Forget the Bubbles

FEBRUARY 24, 2025

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. Between 2002 and 2015, 200 infants with pertussis were placed on ECMO, but only 56 survived, representing a survival rate of just 28%.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Don't Forget the Bubbles

JULY 5, 2023

Do not use pethidine since it can cause seizures and CNS hyperexcitability. Anemia ; 2015.DOI:10.1155/2015/791498. DOI:10.1155/2015/791498. Plast Reconstr Surg – Glob Open 2015; 3: 83–86. Alternatives to morphine are hydromorphone or fentanyl. References Adewoyin AS. Jain S, Bakshi N, Krishnamurti L. 2014; 349–356.

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Blood Transfusions Stroke Dehydration Sepsis 126

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. 2015) Sticks and stones: investigating rude, dismissive and aggressive communication between doctors Clinical Medicine 15(6) 541-545 Clark C. A head CT scan was arranged. and Whitelaw B.

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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., 2015 Dec;21(6 Neuroinfectious Disease):1714-28 Carlson JA, Dabiri G, Cribier B, Sell S. Neurosyphilis.

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EMS Infectious Diseases CDC Research 115