The Skeptics' Guide to EM

NOVEMBER 18, 2017

[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Critical Care Medicine 2017. display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Critical Care Medicine 2017. Will treating with antipyretics prevent a febrile seizure?

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

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. 2017 Dec;10(1):1. Epub 2017 Jan 25. 2017, 43:226-8. Int J Emerg Med.

Emergency Department 92

Emergency Department Soft Tissue Injuries Operations Airway Management 92

Advanced Emergency Nursing from AENJ

MAY 14, 2017

" Some epileptic seizures will be heralded by a loud inspiratory "cri du epilepsie" as the diaphragm contracts in spasm and by the strong negative pressure against a partially closed larynx (in the form of a Müller maneuver or "reverse Valsalva maneuver") similar to that made by a partially-obstructing laryngospasm.

Dislocations 40

Dislocations Emergency Nursing Seizures Fractures 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

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. 2017 Sep-Dec;21(3):101-104. Now that is an interesting consult!

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

Downeast Emergency Medicine

APRIL 26, 2021

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] Lastly, the use of TXA is not without risk.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

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

ACEP Now

APRIL 2, 2024

They are found in large numbers in the mouth, throat, and stomach, as well as throughout the body. 8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. 2018:bcr-2017- 224085. These receptors are activated by capsaicinoids, noxious heat (greater than 109.4 BMJ Case Rep.

Burns 40

Burns Poisoning Seizures Stroke 40

ACEP Now

MARCH 11, 2025

16 An elevated amylase suggests repetitive vomiting as well. London: National Institute for Health and Care Excellence (NICE); 2017 May. Serum phosphate should be obtained in all patients with eating disorders as hypophosphatemia is suggestive of refeeding syndrome, which can be fatal. Dermatoendocrinol. 2009;1(5):268-270.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

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

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

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants. 2017 Jun 28;12(6):e doi: 10.1371/journal.pone.0180121.

EMS 97

EMS Infectious Diseases Sepsis Hospitals 97

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

Dr. Smith's ECG Blog

DECEMBER 5, 2019

This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. Syncope and ST Segment Elevation. And another finding.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Pediatric EM Morsels

OCTOBER 6, 2023

Let us take a moment to review Typhoid Fever in children : Typhoid Fever: Basics Salmonella enterica serotype Typhi is the causative bacteria and represents 75% of cases of enteric fever (GBD 2017) Salmonella enterica serotypes Paratyphi A, B and C cause Paratyphoid fever which has clinically indistinguishable features.

Pediatrics 164

Pediatrics CDC Seizures Documentation/Coding 164

Dr. Smith's ECG Blog

JANUARY 21, 2023

The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. CMAJ 2017 Vassallo SU, Delaney KA, Hoffman RS, et al. Seizure activity was witnessed in the ED. Is this takotsubo? J wave syndromes.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

EMDocs

NOVEMBER 4, 2024

million patient complaints in 2017, making it the second most common ED complaint. She denies any trauma, swelling, or redness in the joints, as well as fever or weight loss. National Hospital Ambulatory Medical Care Survey (NHAMCS) 2017 Emergency Department Summary Tables (2017). 2017 Apr 4;166(7):514-530.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

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. Semin Ultrasound CT MR 2017, 38 (4), 345-356. J Neurointerv Surg 2017, 9 (2), 122-126. Kaller, C.

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

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Do not use pethidine since it can cause seizures and CNS hyperexcitability. Pediatr Allergy, Immunol Pulmonol 2017; 30: 191–201. Anemia ; 2015.DOI:10.1155/2015/791498.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Moreover, it does not follow a coronary distribution very well. The QTc looks prolonged ( well over half the R-R interval ) although accurate QTc assessment becomes challenging at this rapid a rate. By ECG alone: it is suspicious for stress cardiomyopathy, or takotsubo, due to the diffuse ST Elevation: II, III, aVF AND I and aVL.

EKG/ECG 88

EKG/ECG Resuscitation EMS Seizures 88

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. 2017 Jul;70(1):52-62.e6. Epub 2017 Mar 2.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

EMDocs

MARCH 11, 2024

33 In areas without potable tap water or reliable sources of safe water, bottled water should be used for drinking, as well as brushing teeth and washing/preparing food. Among children, hypoglycemia is common and can lead to seizures. Cholera vaccines: WHO position paper – August 2017. Published online August 25, 2017.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

Pediatric Education

SEPTEMBER 1, 2024

Smallpox is an ancient disease and an especially well-known cause of severe morbidity and mortality and therefore was used as a curse or epiphet. The lesions are 7-10 mm in diameter, round, firm, deep-seated and well circumscribed… ” Lesions tend to appear more on the forearms and face than rest of the body.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Sepsis 40

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. A review of systems is notable for nausea and vomiting but no diarrhea. doi:10.1136/bmj.327.7426.1271

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75