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Gelastic Seizures: No Laughing Matter

Pediatric EM Morsels

Nicotera, 2024 ] Can have associated autonomic features also: [ Bacus, 2023; Striano, 2017 ] Flushing Pupillary dilation Tachycardia Altered respirations Rare seizure type ~1% of all epilepsies Likely under-reported Ages: Typically seen in children ages 4 to 10 years. 2017 Jun;58 Suppl 2:12-15. Can even become status gelasticus.

Seizures 260
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Agitation Podcast Series Episode 3: Pharmacologic management of agitated children

PEMBlog

Psychiatr Clin North Am. 2017 Sep;40(3):397-410. PMID: 35545394; PMCID: PMC9096567. New A, Tucci VT, Rios J. A Modern-Day Fight Club? The Stabilization and Management of Acutely Agitated Patients in the Emergency Department. doi: 10.1016/j.psc.2017.05.002. 2017.05.002. PMID: 28800797.

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Universal Depression Screening Leads to Unnecessary Harm

Sensible Medicine

In a 2017 Lancet trial , 10,190 personnel from the UK military were randomized to post-deployment depression screening or no screening. Medical illness, other psychiatric illness, and life circumstances can lead to positive results on the PHQ-9. Similar mental health services were available to both groups. vs 12.1%).

Military 144
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PEM Currents – Agitation in Children – Episode 3: Pharmacologic Management

EMDocs

Podcast: Play in new window | Download (Duration: 19:53 — 27.3MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. Psychiatr Clin North Am. 2017 Sep;40(3):397-410. mg/kg/dose PO; 0.2-0.3

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Managing the Patient with Alcohol Intoxication

RebelEM

It may be mistaken for acute intoxication, psychiatric illness, or other occult pathology. Consider a psychiatric consult (and labs needed for psychiatric admission) or check blood work if there is a concern for concomitant underlying medical pathology as a cause of hallucinations. Acta Psychiatr Scand. Alcohol Alcohol.

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Tranq dope (fentanyl-xylazine combination): A new horizon in opioid withdrawal treatment

ALiEM

2017 Jun;32:660-6. J Am Psychiatr Nurses Assoc. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention. Journal of general internal medicine. PMID 28194688 D’Onofrio G, O’Connor PG, Pantalon MV, et al. Cureus 16(9): e69274. 2023;29(6):470-476.

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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

She had an uneventful ICU course and was extubated for ongoing care with the inpatient psychiatric service. 2017 Oct 1;177(10):1520-1522. She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval.

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