Taming the SRU

FEBRUARY 5, 2024

1) However, it wasn’t until the 1890s that purposeful, successful, and safe attempts to access this fluid were documented (2). Metropolitan Museum of Art, CC0, via Wikimedia Commons The ancient Egyptian physician Imhotep is often credited with the discovery of cerebral spinal fluid (CSF) —over 5,000 years ago! (1)

Infectious Diseases 95

Infectious Diseases Seizures Ultrasounds Sepsis 95

Taming the SRU

JUNE 3, 2024

Get a blood gas when possible to help guide your ventilation. glenn, haffner, and jackson In Flight Emergencies: As a responding physician to an in-flight emergency, you may recommend diverting the plane, however, the captain (lead pilot) will make the final decision.

Shock 89

Shock Seizures Airway Management Documentation/Coding 89

ACEP Now

APRIL 2, 2024

1 In severe cases altered mental status, seizures, coma, or even death have been observed. 4 The association between ackee ingestion and the illness was initially recognized in 1875 and officially documented in 1904. Similarly, death is more prevalent in children with Toxic Hypoglycemic Syndrome compared to adults.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

EMDocs

JULY 3, 2023

4 Common symptoms of SAH on presentation include vomiting, neck stiffness, altered mental status or decreased level of consciousness, hemiparesis, and seizure-like activity. This neurological evaluation should include assessment and documentation of the GCS, the presence of any neurologic deficits, and an NIHSS.

Seizures 85

Seizures Stroke Outcomes EMS 85

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. There have been documented cases of overdose, and of note, there is no known antidote.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

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 93

Sepsis Administration Fractures Documentation/Coding 93

Pediatric EM Morsels

AUGUST 18, 2023

None of the patients were documented to have joint disease at follow up. Myth # 2: Neurologic affects Nervous system adverse events mostly include central concerns (ex, seizures, headaches, dizziness, lightheadedness, sleep disorders, hallucinations) and peripheral neuropathy. There were 2523 children included.

Pediatrics 130

Pediatrics Infectious Diseases Hospitals Seizures 130

Pediatric EM Morsels

OCTOBER 6, 2023

Obasi 2020) Hepatic and splenic abscesses have been documented in children, and splenic rupture is particularly associated with cases of MDR typhoid fever. Britto 2017) There have been several neurological complications associated with typhoid fever in pediatric patients (Britto 2017): It has an increased association with febrile seizures.

Pediatrics 161

Pediatrics CDC Seizures Infectious Diseases 161

ACEP Now

DECEMBER 10, 2023

5 Symptoms of milkweed poisoning may include abdominal discomfort, nausea, vomiting, diarrhea, weakness, lethargy, and confusion, progressing to seizures, heart rhythm changes, and bradycardia. He was observed for several hours and eventually discharged with minimal intervention.

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

Downeast Emergency Medicine

APRIL 26, 2021

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] Lastly, the use of TXA is not without risk.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Sensible Medicine

JUNE 30, 2023

By the time she died, this management had included intravenous fluids, pain medications, antiemetics, and seizure medications. ” I documented those words in my progress note that day. I managed her evaluation and her care while she remained an outpatient. Then, everything changed.

Hospitals 94

Hospitals Hospice Resuscitation COPD 94

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. This includes subdural hematomas, comas, paraplegia, quadriplegia, fractures and seizure disorders, regardless of the time interval between the injury and death. Brent, Nancy J.,

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Taming the SRU

JUNE 6, 2023

million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 63

Documentation/Coding Seizures Wellness Psychiatric 63

EMDocs

JUNE 9, 2023

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 77

EMS Documentation/Coding Pediatrics Psychiatric 77

Mind The Bleep

FEBRUARY 7, 2024

meningitis), intractable seizures, low GCS, increased risk of aspiration or airway obstruction such as pathological obstruction (e.g. Should also document presence of shunt, size and direction. hypoxic ischaemic encephalopathy), metabolic disorders, or muscular problems. Inability to protect the airway can be due to brain injury (e.g.

Wellness 52

Wellness Seizures Documentation/Coding Operations 52

EB Medicine

AUGUST 1, 2018

Jeff: Medicinally, cannabinoids are currently used in the treatment of chronic pain syndromes, complications of multiple sclerosis and paraplegia, weight loss due to appetite suppression in HIV/aids, chemotherapy-induced nausea and vomiting, seizures, and many other neuropsychiatric disorders.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Don't Forget the Bubbles

JULY 26, 2023

Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. The presence of these pathways is documented inutero and they usually regress by around 20 weeks gestation. A 12 year old girl was heard to be coughing in the middle of the night.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

MAY 30, 2023

Generally accepted (and some airlines spell it out) that they are assuming the liability even for you helping Documentation: To protect yourself (and the airline), will/should make documentation of what happened. Airline companies have been sued. Each airline generally has their own protocol.

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Pediatric Emergency Playbook

APRIL 1, 2016

S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. for the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Difficult to interpret lactates when a patient is on an epinephrine drip. Am J Cardiol. 2012;110:284 –289.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. This shows that much of the apparent R'-wave in V1 and V2 is really a downsloping ST segment. Bayes de Luna, A et al.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

The best documented cormorbidity is sickle cell disease, although other pro-thrombotic conditions also put the child at risk. The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI. 1986; 108(2):198-203.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. Diagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: limitations of ST-segment elevation in standard and extended ECG leads.

EKG/ECG 52

EKG/ECG Seizures Documentation/Coding Outcomes 52

Don't Forget the Bubbles

JULY 5, 2023

Do not use pethidine since it can cause seizures and CNS hyperexcitability. However, there are documented adverse events such as haemorrhagic cerebrovascular accidents or recurrence of VOC after drug withdrawal, which represent a drawback in its regular use. Alternatives to morphine are hydromorphone or fentanyl.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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. Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52