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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

Doing so will commonly show one or more electrode leads to be loose — OR — the patient to be shaking, trembling, shivering, having a seizure, scratching or other obvious cause of the bizarre deflections seen. The January 30, 2018 post — for PTA. Figure-3: I've reproduced this tracing from ECG Blog #148 ( See text ). =

Shock 411
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Unpacking the PEACH Trial: What is Levetiracetam’s Role in Spontaneous Intracerebral Hemorrhage?

RebelEM

Levetiracetam is frequently used to prevent seizures in patients with conditions such as ICH, traumatic brain injury (TBI), supratentorial neurosurgery, and subarachnoid hemorrhage (SAH). About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ). Article : Peter-Derex et al.

Seizures 123
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Cannabidiol in refractory status epilepticus

Don't Forget the Bubbles

A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Despite this, the CFAM still showed ongoing electrical seizure activity.

Seizures 122
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Super Refractory Status Epilepticus

Don't Forget the Bubbles

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
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SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen?

The Skeptics' Guide to EM

Date: December 13th , 2018 Reference: Murata et al. Acetaminophen and febrile seizure recurrences during the same fever episode. 2018 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Associate Professor for the University of Leicester’s SAPPHIRE group. Pediatrics. Pediatrics.

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TXA in head injuries

Don't Forget the Bubbles

As in CRASH-2, TXA did not show a significant increase in thrombotic events or seizures. published in 2018, looked at 1900 matched pairs of injured children under 12, half of whom received TXA. 2018 Dec;19(12):e637-e642. TXA conferred no survival benefit in adult patients with isolated head injuries. The evidence is a mixed bag.

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Congenital Syphilis

Pediatric EM Morsels

Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. Worldwide, congenital syphilis complicates about 1 million pregnancies / year. Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally. Rates of congenital syphilis are increasing.