Dr. Smith's ECG Blog

DECEMBER 26, 2020

Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. Thus, it seems that two mistakes may have inadvertently led accidentally to the appropriate administration of thrombolytics!! Long-term outcome is unknown.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. hypertensive emergency, need for thrombolytic administration) [1]. His blood pressure (BP) is 220/120 mmHg.

Stroke 100

Stroke Outcomes EMS Seizures 100

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Antiemetics as needed.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

EMDocs

MAY 25, 2023

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 mg/kg or 10 mg Intravenous lorazepam 0.1

Seizures 90

Seizures Administration Anaphylaxis Outcomes 90

EMDocs

SEPTEMBER 25, 2023

Introduction: Since the late 1990s, RSI has been the gold standard of emergency intubations (5). First described in 1970, RSI with the near-simultaneous administration of a sedative agent and NMBA has been shown to have increased first-pass success compared with intubation facilitated by a sedative alone (6,7). Int J Emerg Med.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

EMDocs

JANUARY 17, 2024

She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). The US Food and Drug Administration (FDA) approved benzonatate in 1958 for cough relief in patients ≥ 10 years. Benzodiazepines are first-line therapy for seizures. 11) A bolus dose at 1.5

Poisoning 91

Poisoning Seizures Pediatrics EMS 91

EMDocs

FEBRUARY 15, 2024

8 However, it is not considered first line in treatment of anticholinergic toxicity and is not available in all emergency departments. Physostigmine does not reverse seizures or dysrhythmias. Physostigmine does not reverse seizures or dysrhythmias. 9 Physostigmine dosing: 0.5-2 mg; for children, can use 0.02

Hyperthermia / Hypothermia 111

Hyperthermia / Hypothermia Poisoning Seizures COPD 111

Taming the SRU

JANUARY 26, 2024

Wosiski-Kuhn and Stothers BP cuff sizing: Using a cuff too large results in lower SBP, using too small results in higher BP VTE risk with hormonal contraception and NSAIDS Isolated use + and contraception leads to IRR of 7.2 10 or greater days and high or moderate risk hormonal contraception amplifies risk to IRR of 44.8

Stroke 59

Stroke EKG/ECG Seizures Outcomes 59

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Four Components to Successful Pain Management and Intranasal Medication Administration Right drug, right dose, right patient, right timing Right Drug – Not every medication is easily amenable to intranasal administration. Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. 1 In severe cases altered mental status, seizures, coma, or even death have been observed. Food and Drug Administration website. Clin Toxicol. 2006;44(3):267-73. Ajayi AM, Ayodele EO, et al.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

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. J Emerg Med. Acad Emerg Med. J Emerg Med. Emerg Med J.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

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. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EB Medicine

FEBRUARY 1, 2019

This month, we’re tackling an incredibly important topic - evaluation and management of life threatening headaches in the Emergency Department. Nachi: In addition to monitoring ABCs, early care involves the administration of analgesics and anti-emetics. Seizures are very common as well. That’s quite a list.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. Pearls and Pitfalls CT Angiography has become a more readily available tool for diagnosis in the emergency department though requires an understanding of its specific uses and indications.

Stroke 106

Stroke Radiology Radiology Emergency Department 106

Taming the SRU

NOVEMBER 18, 2024

This blog post will attempt to serve as a resource to assist in the evaluation of persistent/intractable hiccups and cover the physiology, classification, associated disease processes, evaluation and management strategies of hiccups in the emergency department. mg IV Olanzapine 2.5

Stroke 87

Stroke Administration COPD Dehydration 87

Taming the SRU

SEPTEMBER 1, 2023

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

Sepsis 96

Sepsis Fractures Documentation/Coding Administration 96

EMDocs

JANUARY 22, 2025

What are the pharmacokinetics of naloxone and how do they vary by route of administration? Is there an ideal observation period in the emergency department after reversal with naloxone? These included seizures, delirium, ARDS, hypotension, hypertension, and aspiration. drug seizure data, 2011-2016. Acad Emerg Med.

Seizures 97

Seizures Administration Emergency Department Poisoning 97

EMDocs

JUNE 7, 2023

Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Case Follow-up: The patient required benzodiazepine administration for seizure management and subsequent intubation for airway protection. Parenteral organophosphorus poisoning in a rural emergency department: a case report.

Poisoning 98

Poisoning Airway Management Seizures PPE 98

Taming the SRU

JUNE 6, 2023

HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5 million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65

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., 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

Psychiatric 90

Psychiatric Seizures Emergency Department Pediatrics 90

PulmCCM

OCTOBER 23, 2023

Answering this research question has been made more difficult by pip-tazo’s possible status as a pseudo-nephrotoxin (elevating creatinine levels in the blood without harming the kidneys) and frequent co-administration with vancomycin, a known nephrotoxin. Paxlovid also did not reduce symptoms of Covid-19 in that trial.

Hospitals 98

Hospitals COPD Emergency Department CDC 98

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. Among children, hypoglycemia is common and can lead to seizures.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

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. Ann Emerg Med. Ann Emerg Med. 2024.01.007.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

Don't Forget the Bubbles

JULY 5, 2023

Do not use pethidine since it can cause seizures and CNS hyperexcitability. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. Alternatives to morphine are hydromorphone or fentanyl. She complained of cough and runny nose for 3 days.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126