Dr. Smith's ECG Blog

JUNE 17, 2016

He had a seizure this morning and rolled out of bed unable to get up. There were no injuries and no chest pain and he appeared well. The diagnostic problem posed in today's repost from June 17, 2016 is a perfect example of this. The patient is a 36yo man who was seen for a seizure. There was no chest pain.

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. How useful these would have been to let us know how well the patient was oxygenating and ventilating!

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 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. 2016; 417: 54–56.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

Pediatric EM Morsels

NOVEMBER 3, 2023

ovale to cover the hypnozoite that can stay dormant in the liver and cause a secondary infection in the future Severe Malaria IV artesunate is currently the accepted first line treatment Previously IV quinine was first line, however it was associated with higher incidence of hypoglycemia, cardiac dysrhythmias, seizures, and comas. vivax , P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Don't Forget the Bubbles

JANUARY 24, 2024

Four-year-old Fern is a previously healthy girl who presents with a febrile illness and seizures. Seizure activity did not respond to either first or second-line treatments, so she needed rapid sequence induction and transfer to PICU for ongoing anaesthesia and management. What causes Super Refractory Status Epilepticus?

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Consider intubation for patients with airway compromise, respiratory failure, altered mental status, or seizure. 5 Seizure: IV benzodiazepine first line, barbiturates as second line.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

EMDocs

JANUARY 4, 2024

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 In one study, almost all patients who went on to develop seizures had tachycardia prior to the seizure.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. Eclampsia (B) is characterized by the onset of seizures in a woman with preeclampsia (hypertension and proteinuria), but it typically does not present with the sudden onset of respiratory distress and profound hypotension described here.

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

Don't Forget the Bubbles

APRIL 7, 2025

It can present with jitteriness, poor feeding, prolonged jaundice, seizures, bluish skin discolouration (cyanosis), lethargy, or even acute collapse. Depending on the size and location, children may develop neurological symptoms, such as seizures, developmental delays, or visual disturbances due to compression of the optic pathways.

Dehydration 72

Dehydration Pediatrics Administration Seizures 72

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

EMDocs

AUGUST 22, 2023

Published 2016 Jan 29. In cardiac arrest, EtCO 2 is dependent on compressions AND the underlying cause. PMID: 24381677 Bou Chebl R, Madden B, Belsky J, Harmouche E, Yessayan L. Diagnostic value of end tidal capnography in patients with hyperglycemia in the emergency department. BMC Emerg Med. Eur Respir J. 2010;35(4):735-741.

Emergency Department 94

Emergency Department Blood Transfusions Resuscitation Sepsis 94

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. 2016 Sep;117 Suppl 1:i9-i13. Minimal histamine release. Pain upon injection.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

PEMBlog

MARCH 27, 2024

2016 Jan;37(1):3-15; quiz 16-7, 47. Or, well, the ringer called me. They include neurologic dysfunction, which is one of the most common that includes things like developmental delay, regression, AKA loss of developmental milestones, hypotonia, encephalopathy, or seizures. In: StatPearls [Internet]. Pediatr Rev. PMID: 26729777.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

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. 2016 Jul;32(7):435-9. 2016 Apr 19;4:CD005220. Headache plus… it’s unilateral and new for the patient. J Neurosurg.

Pediatrics 52

Pediatrics Emergency Department Seizures Wellness 52

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

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. On arrival at hospital the child was well with normal observations.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

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

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. This includes subdural hematomas, comas, paraplegia, quadriplegia, fractures and seizure disorders, regardless of the time interval between the injury and death. April 6, 2016.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Taming the SRU

APRIL 17, 2023

Thankfully, some of the more common and/or dangerous plant poisonings have been well-categorized, and are summarized below. Deadly Nightshade and Jimson Weed are well known among the poisonous plants. Severe cases may result in seizures or coma. McGraw Hill; 2016. Now that is an interesting consult! Address life-threats.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

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

EMDocs

NOVEMBER 4, 2024

Headache red-flag characteristics include neurological symptoms, thunderclap nature, syncope, trauma, immunocompromised, coagulopathy, fever, rash, seizure, nuchal rigidity, altered mental status, pregnancy, temporal tenderness, jaw claudication, and cancer history. doi:10.1136/tsaco-2016-000064 Zink KA, Mayberry JC, Peck EG, Schreiber MA.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

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. Finally, much of this correlates well with The new Canadian Syncope Arrhythmia Risk Score , just published in 2016, results of which are given below in the Annotated Bibliography.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Pediatric Education

JUNE 25, 2023

Borate toxicity can cause abdominal pain, diarrhea, emesis, fever, irritability, seizures, and death. Borates can cause skin irritation and there can be some reproductive changes as well. Toxic borate exposure can occur through inhalation, or oral and dermal routes with non-intact skin being a bigger problem.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Outcomes 40

EB Medicine

FEBRUARY 1, 2019

Gabrielle Procopio, a PharmD, have done a fantastic job parsing through the literature, which included over 500 abstracts, 89 full text articles, guidelines from ACEP and the American Academy of Neurology, as well as canadian and european neurology guidelines, to summarize the best evidence based recommendations for you all.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

How well does the computer interpretation perform? -- in this case, the computer diagnosed STEMI but the patient had Fever with Brugada _ _ Fever and Brugada-- Important articles The literature below shows that fever-induced Brugada is indeed a high risk for an arrhythmic event. Heart Rhythm 2016. Syncope and ST Segment Elevation.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

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. Stroke 2016, 47 (1), 273-281. 8 The data in Mayer et al. positivity rate on CTA for BCVI. 12) Demchuk, A.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. 2016; 15: 32.

Pediatrics 164

Pediatrics CDC Seizures Documentation/Coding 164

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Don't Forget the Bubbles

JULY 10, 2023

Seizures may also occur, as may paralysis. Analgesia is often necessary for the acute phase, as well as antibiotics for secondary bacterial infections. Global epidemiology of vaccine-derived poliovirus 2016–2021: A descriptive analysis and retrospective case-control study. Quadriplegia is more common in adults. Edition 21.

Seizures 75

Seizures Operations Pediatrics Hospitals 75

Don't Forget the Bubbles

FEBRUARY 24, 2025

They were a well-grown, term infant born in good condition. 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. 2016 Oct;74(7):ftw087. The other investigations are unremarkable, including a normal CT head. Clin Infect Dis.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

EMDocs

JANUARY 6, 2025

She presents with a seven-day history of fever, fatigue, and myalgias associated with decreased oral intake and an episode of seizure-like activity three hours prior to arrival. Additionally, there is no family history of seizure disorders. International Monetary Fund; 2016. She also endorses dysuria, cough, and neck rigidity.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75