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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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Cardiac Rhythms/ECG Module

Don't Forget the Bubbles

Add into this that the majority of children will be in normal sinus rhythm (NSR) by the time of assessment so to truly identify those who have something wrong we have to be confident in identifying arrhythmias where they are present and critical when analysing an ECG in NSR. All were examined and 98% had an ECG.

EKG/ECG 98
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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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Grand Rounds Recap 5.22.24

Taming the SRU

If you or your patient do not have a watch capable of providing you with an ECG, consider asking those on board to allow you to borrow theirs. Get a blood gas when possible to help guide your ventilation. Some newer AED's have the capability of providing you with a rhythm strip.

Shock 91
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A "normal ECG" on a busy night

Dr. Smith's ECG Blog

At 3:55 AM during that kind of a night shift, this ECG (among many others) was brought from triage for review by my team. We knew only that the ECG belonged to a man in his 50s with chest pain and normal vitals. Here is the computer interpretation: So we have a triage-computer-normal ECG. No prior available.

EKG/ECG 40
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Popular Antiobesity Medications Bring New Challenges to Emergency Physicians

ACEP Now

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.

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Chemical Burns

Mind The Bleep

Circulation Assess heart rate, blood pressure, peripheral and central CRT, pulses and 3 lead ECG. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. Administer high-flow oxygen if indicated and consider arterial blood gas ( ABG ).

Burns 52