RebelEM

SEPTEMBER 7, 2023

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 ). PMID: 35963261.

Seizures 132

Seizures Stroke Outcomes Research 132

EMDocs

MARCH 4, 2025

Neurologic deficits, seizures, cognitive issues, hearing loss. Give acyclovir If there is concern for HSV encephalitis (focal neurologic deficits, seizures, markedly depressed mental status, or immunocompromise) The mortality rate for HSV encephalitis is up to 70%. Epub 2022 Dec 28. Mortality rate is 10-30%. Am J Emerg Med.

Infectious Diseases 83

Infectious Diseases Seizures Poisoning Sepsis 83

Pediatric EM Morsels

AUGUST 23, 2024

Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898. PMID: 37316210. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels.

Seizures 281

Seizures Pediatrics Academics Emergency Department 281

Pediatric EM Morsels

AUGUST 9, 2024

Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. 2022 Dec 27;14(12):e33009. PMID: 37604180.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

EMDocs

SEPTEMBER 24, 2024

Episode 107: Eclampsia Definition: Severe hypertensive disease of pregnancy (HDP) with new onset tonic-clonic, focal, or multifocal seizures or unexplained altered mental status in a patient who is pregnant or postpartum and there’s no other causative etiologies. Approximately one third have no findings of preeclampsia before the seizure.

Seizures 105

Seizures Stroke EKG/ECG 105

Taming the SRU

DECEMBER 17, 2024

2022 Sep 11;5(5):e827. Available from: [link] Aghsaeifard Z, Heidari G, Alizadeh R. Understanding the use of oral rehydration therapy: A narrative review from clinical practice to main recommendations. Health Sci Rep. doi: 10.1002/hsr2.827. PMID: 36110343; PMCID: PMC9464461. Perez SR, Keijzers G, Steele M, Byrnes J, Scuffham PA.

Dehydration 84

Dehydration Fluid Resuscitation Administration Resuscitation 84

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. On ED arrival GCS is 3, there are rapid eye movements to the right but no other apparent seizure activity. Check glucose, obtain imaging, stop the seizure. They administer two doses of 10 mg midazolam IM.

Seizures 98

Seizures Documentation/Coding EKG/ECG Emergency Department 98

EMDocs

JANUARY 4, 2024

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

Don't Forget the Bubbles

JUNE 30, 2023

As in CRASH-2, TXA did not show a significant increase in thrombotic events or seizures. Next of interest is a secondary analysis of the MATIC study – the MA ssive T ransfusion I n C hildren study, published in 2022. 2022 May;55:103-110. Epub 2022 Feb 7. 2022; 29: 862– 873. But that’s not where it ends.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

EMDocs

DECEMBER 19, 2023

Accessed August 25, 2022. Accessed August 25, 2022. McGraw Hill; 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. Accessed August 25, 2022. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH.

Poisoning 105

Poisoning Seizures Anaphylaxis Burns 105

Broome Docs

OCTOBER 31, 2022

2022 Jan;48(1):78-91. Safety and efficacy of prophylactic levetiracetam for prevention of epileptic seizures in the acute phase of intracerebral haemorrhage (PEACH): a randomised, double-blind, placebo-controlled, phase 3 trial. 2022 Sep;21(9):781-791. 2022 Sep 15;387(11):989-1000. 2022 Sep 18. Epub 2022 Apr 28.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

EMergucate

SEPTEMBER 14, 2022

A 64 year old male presents to ED after multiple seizure episodes that day. It was reported that the patient would have 20 seconds of seizure activity and then make a full recovering. The patient h…

Seizures 52

Seizures EKG/ECG 52

Pediatric EM Morsels

APRIL 7, 2023

Updated 2022 Jul 18]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Observation, interaction with patient, as well as parent information is key to bring the whole picture together! Atherosclerosis. 2013 Aug;229(2):496-503. doi: 10.1016/j.atherosclerosis.2013.05.006. 2013.05.006. Epub 2013 May 16. PMID: 23746538.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

EMDocs

APRIL 10, 2024

She reportedly received a landmark guided peripheral nerve block with bupivacaine and shortly thereafter developed generalized seizures. 1,5] CNS symptoms include: Seizure, coma, altered mental status. [1] 2,9] Benzodiazepines are the first line treatment for seizures. McGraw Hill; 2022. How do we manage patients in LAST?

Advances Cardiac Life Support (ACLS) 111

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 111

Don't Forget the Bubbles

SEPTEMBER 6, 2023

A 2022 CDC report showed an overall trend of increasing mental health-related ED visits for children and young people aged 0-17 from 2019 to 2022. Published 2022 Jun 13. Published 2022 Feb 25. Mental health-related ED visits for children and young people are common and have been on the rise during the last decade.

Psychiatric 119

Psychiatric Sexual Assault Emergency Department Pediatrics 119

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]. 2022 Mar 2;83(3):1-12. Epub 2022 Mar 4. However, if PEG is not immediately available, irrigation with water can be initiated. Kirkpatrick JJ, Enion DS, Burd DA. PMID: 35377199.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMergucate

SEPTEMBER 13, 2022

A 64 year old male presents to ED after multiple seizure episodes that day. It was reported that the patient would have 20 seconds of seizure activity and then make a full recovering. The patient h…

Seizures 40

Seizures EKG/ECG 40

ALiEM

OCTOBER 4, 2023

1, 5] Muscarinic symptoms (Common acronyms SLUDGE or DUMBBELLS) Salivation, emesis, diarrhea, and lacrimation Miosis Seizures Bradycardia, bronchospasm, and bronchorrhea are usually the cause of death. Use benzodiazepines such as diazepam or midazolam for seizures. Epub 2022 Dec 30. May 24, 2022. Provide supportive care.

Poisoning 78

Poisoning Seizures Hospitals 78

EMDocs

JANUARY 17, 2024

Neurologic symptoms: Encephalopathy, seizures, or coma (5,7) Cardiovascular symptoms: Hypotension, conduction disturbances, ventricular tachycardia or fibrillation, pulseless electrical activity, or asystole (10) Breaking, crushing, or chewing the capsules can produce numbness, choking, bronchospasm or laryngospasm. (5) 2022-057779.

Poisoning 89

Poisoning Seizures Pediatrics EMS 89

Don't Forget the Bubbles

AUGUST 12, 2024

Do we need seizure prophylaxis? Children and young people have lower seizure thresholds than adults. Following TBI, seizures are common and may be missed in children and young people who are sedated and paralysed. Either levetiracetam or phenytoin can be used for seizure prophylaxis. Published 2022 Nov 20.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Pediatric EM Morsels

AUGUST 18, 2023

Myth # 2: Neurologic affects Nervous system adverse events mostly include central concerns (ex, seizures, headaches, dizziness, lightheadedness, sleep disorders, hallucinations) and peripheral neuropathy. Morley 2022) This myth is: BUSTED. Symptoms resolved within 24 hours of withdrawal of the medication. Pediatr Infect Dis J.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Don't Forget the Bubbles

FEBRUARY 5, 2025

According to the latest figures (2022), there were approximately 6,000 recorded offences where a child was a victim of violence, including physical assault, sexual abuse, and homicide. Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms. TXA in head injuries.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

Mind The Bleep

OCTOBER 20, 2023

They can cause a wide array of symptoms, such as seizures, weakness and dizziness, and typically there are clinical features that actively support the diagnosis of FND. Symptoms of FND -Functional seizures (also can be termed dissociative) -Motor symptoms (e.g. Some have high specificity (positive Hoover’s sign) but low sensitivity.

Seizures 52

Seizures Psychiatric 52

EB Medicine

MARCH 7, 2022

Episode 67 – Managing Postpartum Complications in the Emergency Department – An Interview with Dr. Nicole Yuzuk, Dr. Joseph Bove, and Dr. Riddhi Desai EMplify – March 2022 Interview with the Authors: Nicole Yuzuk, DO, Joseph Bove, DO, and Riddhi Desai, DO Episode Outline: 1.Why Why is this an important topic in EM?

Emergency Department 52

Emergency Department Seizures EMS EKG/ECG 52

EMDocs

MAY 15, 2024

2022 Aug;58:235-244. Epub 2022 Jun 11. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia. References: Koehl JL, Koyfman A, Hayes BD, Long B. Am J Emerg Med. PMID: 35717760.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

MAY 28, 2024

2022 Aug;58:235-244. Epub 2022 Jun 11. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS). References: Koehl JL, Koyfman A, Hayes BD, Long B. High risk and low prevalence diseases: Acute chest syndrome in sickle cell disease. Am J Emerg Med.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

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. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. What well-known adverse reaction results from ingestion of the pictured mushroom?

Seizures 67

Seizures Academics Wellness 67

JournalFeed

NOVEMBER 12, 2022

The JournalFeed podcast for the week of Nov 7-11, 2022. Status: Ketamine Spoon Feed In children with refractory status epilepticus, around 3/4 of patienats who were started on a ketamine infusion had seizure termination or improvement. These are summaries from just 2 of the 5 article we cover every week!

Seizures 40

Seizures 40

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. 2022 Jul;53(7):e282-e361. Epub 2022 May 17. doi: 10.1161/STR.0000000000000407.

Stroke 99

Stroke Outcomes EMS Seizures 99

ACEP Now

FEBRUARY 11, 2024

Patient C, a 27-year-old female with a history of epilepsy, taking valproate and endorsing adherence, is then brought in by ambulance for a witnessed seizure. This is her first seizure in six years. This patient had her first seizure in years despite adherence to her valproate for management of her epilepsy. 2006;47(12):2207.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

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. Amer J Rad. Zhou and Xia.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Northwestern EM Blog

JANUARY 10, 2022

Hypertonic saline is not only indicated for seizures, coma, suspected cerebral herniation or focal neurological deficits as noted above. Seizures attributed to hyponatremia need treatment ASAP. 2022, Jan 10). When consulting nephrology for hyponatremia, please have a urine sodium, potassium, and creatinine at the ready.

Administration 52

Administration Seizures Emergency Department Wellness 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. 2022, Jan 24).

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. Accessed 2022, [link]. The GCS must be obtained through interaction with the patient (i.e., Prehosp Emerg Care. J Safety Res.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

APRIL 13, 2023

2022 Pre-AeRATE Trial: use of HFNC for preoxygenation and apneic oxygenation showed no difference in lowest SpO2 during first intubation attempt when compared with usual care. EtOH, amphetamines, or cocaine) Prescription drugs (i.e. cuffed ETT) preloaded and intubate through the stoma if PPV needed Infection (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Education

MARCH 3, 2024

Eclampsia is a severe complication of pre-eclampsia that has new onset seizures. doi:10.25122/jml-2022-0264 Dimitriadis E, Rolnik DL, Zhou W, et al. .” Estimate are between 1 – 5.6% of pregnancies have pre-eclampsia. Pre-eclampsia classification is based on symptoms. Pregnancy Hypertens. 2018;12:11-15. doi:10.1016/j.preghy.2018.02.003

Pediatrics 40

Pediatrics Seizures Wellness Stroke 40

Dr. Smith's ECG Blog

JANUARY 15, 2024

The most likely causes of artifact include inconsistent skin-electrode contact and body movement ( scratching, tremor, shivering, coughing, hiccups, brushing teeth, writhing in bed, seizure activity, interference from a mechanical device, etc. ). The October 21, 2022 post — for " artifactual VT". The March 17, 2023 post — for PTA.

EKG/ECG 64

EKG/ECG Wellness Point-of-Care Testing Shock 64