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2023 AHA Update on ACLS

EMDocs

Avoid routine seizure prophylaxis in adult survivors of cardiac arrest (Level 3: no benefit), but treat seizures if they occur (Level 1: strong). For patients with OHCA, use of steroids during CPR is of uncertain benefit. Seizure prophylaxis in adult survivors of cardiac arrest is not recommended. COR 2b, LOE B-R.

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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. EEG Monitoring and Seizures Statements Takeaway: If possible, obtain an EEG to evaluate for seizure activity.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Flumazenil administration is associated with harm in patients who are at increased risk for seizures or dysrhythmias. We recommend the use of benzodiazepines to treat seizures associated with local anesthetic systemic toxicity. Editorial Comment: Give atropine, benzo’s for seizures. COR No Benefit, LOE C-EO.

Poisoning 115
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Grand Rounds Recap 10.4.23

Taming the SRU

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 91
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Brief Resolved Unexplained Event (BRUE)

Mind The Bleep

Some important causes to consider include reflux (very common), seizures, and maltreatment/NAI. It also requires exclusion; even though the child in front of you appears well they still need a thorough history and examination to make sure there isn’t something more concerning going on.

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SGEM Xtra: Strange BRUE

The Skeptics' Guide to EM

. * It is Brief– it lasts less than 60 seconds * It is Resolved– the infant is well appearing by the time we evaluate them * It is Unexplained– If you think this episode can be explained as a seizure or a choking episode or gastroesophageal reflux, it is not a BRUE * The Event includes one or more of the following four things: * Change in Color– Specifically (..)

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??I would have been thankful for, in days of yore …

Advanced Emergency Nursing from AENJ

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. We were even more exotic, with 15 mm endotracheal tube connectors fitted in ours. Disposable BVMs (one at every bedside).