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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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Subarachnoid hemorrhage: ED presentation, evaluation, and management

EMDocs

Introduction SAH has the potential for rapid progression and devastating outcomes. 4 Common symptoms of SAH on presentation include vomiting, neck stiffness, altered mental status or decreased level of consciousness, hemiparesis, and seizure-like activity. Unfortunately, seizures in patients with SAH increase the risk of rebleeding.

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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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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This document is an update of guidelines first published in 2000, and then updated in 2007. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

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Grand Rounds Recap 5.22.24

Taming the SRU

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both. Benefits of transport are evidenced based.

Shock 89
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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.