Mind The Bleep

OCTOBER 29, 2024

These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. Provide detailed documentation of the initial assessment, treatment provided, and the patient’s response to interventions.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

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 91

Shock Seizures Airway Management Stroke 91

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 Seizures Hospitals 130

ACEP Now

JUNE 14, 2024

And the Board approved a new clinical policy, “Critical Issues in the Management of Adult Patients Presenting to the ED with Seizures,” rescinding the 2014 clinical policy with same title. Open applications will be coming soon, but you can find out more and get on the interest list today at acep.org/EDap.

Sexual Assault 52

Sexual Assault Seizures Documentation/Coding EMS 52

Sensible Medicine

SEPTEMBER 13, 2024

She presents with a folder of records and codes for outside EMRs. ” This suggested partial, complex seizures with a post-ictal period. For the last 12-18 months she has been suffering from fatigue, headache, joint pain, and rashes. Sensible Medicine is a reader-supported publication.

Psychiatric 75

Psychiatric Radiology Radiology Documentation/Coding 75

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

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

SEPTEMBER 2, 2024

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. However, cardiac syncope is always a differential diagnosis when someone presents with first time seizures. There are a number of things to look for in an ECG that can hint at arrhythmia as the cause of an apparent seizure.

Seizures 112

Seizures EKG/ECG EMS Stroke 112

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 40

EKG/ECG Seizures Documentation/Coding Outcomes 40

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

EMDocs

MAY 9, 2024

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.

Seizures 105

Seizures Dehydration Documentation/Coding Infectious Diseases 105

PulmCCM

JANUARY 29, 2024

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

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

ACEP Now

OCTOBER 3, 2023

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.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

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

Emergency Medicine Journal

NOVEMBER 28, 2023

SEIZURE (FIT) 715 16 250 35 2.24[1.4 Abstract 2086 Table 1 Presentations Total first presentation over 2021 Total deaths (within 30 days ) Admission Admission (%) Percentage of deaths [CI ] INJURY OF SHOULDER/ARM/ELBOW/WRIST/HAND 8416 4 424 5 0.05[0.018 0.018 , 0.12] INJURY OF HIP/LEG/KNEE/ANKLE/FOOT 7427 15 653 8.8 RASH 935 1 109 11.7

Documentation/Coding 40

Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 40

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

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

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 98

Hospitals Hospice Resuscitation COPD 98

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

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

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

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

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

Taming the SRU

FEBRUARY 22, 2023

STEP-UP Self Physical and Psycological IM-SAFE Illness Medications Stress Alcohol Fatigue Eating Psychological Cognitive Threat/Challenge appraisal: PERCEIVED demands vs. resources Threat appraisal - stress levels excessive, performance impaired – vapor lock (autonomic arousal, tunnel vision, auditory exclusion, loss of time awareness, impaired memory (..)

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 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 98

Seizures Stroke Outcomes EMS 98

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

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

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 95

Sepsis Fractures Documentation/Coding Administration 95

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 164

Pediatrics CDC Seizures Documentation/Coding 164

Taming the SRU

FEBRUARY 3, 2025

These can lead to a wide spectrum of emergent complications including but not limited to cardiac dysrhythmias, seizures, and acute renal failure. This can often become significant enough to precipitate dysrhythmias, seizures, and tetany (20). original document created by author of post. in females and 2.5-7.0

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

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 64

Documentation/Coding Seizures Psychiatric Wellness 64

Don't Forget the Bubbles

DECEMBER 9, 2024

These include CNS irritability (agitation, seizures, irritability), GI disturbance (nausea, vomiting, diarrhoea), and autonomic symptoms (increased heart rate, high blood pressure, sweating and fever). See their website for more: [link] References Abu-Sultaneh S, Iyer NP, Fernndez A, et al. Am J Respir Crit Care Med. 2023;207(1):17-28.

Pediatrics 59

Pediatrics Sepsis Hospitals Administration 59

ACEP Now

OCTOBER 29, 2024

3-6 Additional features include first-degree atrioventricular block, atrial arrhythmias, nocturnal agonal breathing, and seizures. Arrythmias are common during febrile illnesses and in sleep. Figures 4: A. The most common presenting symptoms are life-threatening arrhythmias, syncope, and cardiac arrest. J Am Coll Cardiol. Heart Rhythm.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 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

EMDocs

JANUARY 6, 2025

She presents with a seven-day history of fever, fatigue, and myalgias associated with decreased oral intake and an episode of seizure-like activity three hours prior to arrival. Additionally, there is no family history of seizure disorders. A review of systems is notable for nausea and vomiting but no diarrhea.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75