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Medical Malpractice Insights: Brain Abscess

EMDocs

The triage nurse records the event as a “seizure” lasting 7 minutes. Exam documents that he is alert and oriented but “tired appearing” and “not appearing post-ictal.” ” Sixteen hours later the patient returns comatose after a grand mal seizure at home. Plaintiff : You never acknowledged the alleged “7 minute” seizure.

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The Latest in Critical Care, 1/29/24 (Issue #27)

PulmCCM

Read the document for all the details (it’s not long). EEG Advised, to Rule Out Nonconvulsive Seizures Nonconvulsive seizures are occasionally present in comatose patients after cardiac arrest, undetectable without testing. Seizure prophylaxis was advised against, as there is no evidence for its efficacy.

Seizures 115
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Posterior Reversible Encephalopathy Syndrome (PRES)

Northwestern EM Blog

PRES can quickly devolve from a throbbing, atypical headache to seizures and brain hemorrhage, so intervening as soon as possible with aggressive BP reduction is the goal. Seizure management follows generally conventional practices. Adjunctive magnesium infusions are indicated for pregnant and postpartum cases. Tandlich, M.

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emDOCs Podcast – Episode 86 Tricky Cases Part 2

EMDocs

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.

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PEM Currents – Agitation in Children – Episode 4: Safe prehospital transport

EMDocs

We’re defining “protocol” here as a written document that provides oversight from the medical director about how to assess and treat patients. Reassessment and Documentation After any type of restraint is instituted, careful assessment, re-assessment, and documentation is required. Was the documentation complete?

EMS 89
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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This document is an update of guidelines first published in 2000, and then updated in 2007. 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. 2019;154(7):e191152.

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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.