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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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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

1) However, it wasn’t until the 1890s that purposeful, successful, and safe attempts to access this fluid were documented (2). The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). WHO - Who Needs an LP in the ED?

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Subarachnoid hemorrhage: ED presentation, evaluation, and management

EMDocs

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance.

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Case Report: Toxic Hypoglycemic Syndrome

ACEP Now

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. She reported that these symptoms started two days prior, shortly after consuming a fruit known as ackee.

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Toxicology Answer: Milkweed (Asclepias)

ACEP Now

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.

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Grand Rounds Recap 8.16.23

Taming the SRU

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 (..)

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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?

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