Documentation/Coding Seizures Stroke 
EMDocs
SEPTEMBER 19, 2023
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.
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)
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Taming the SRU
JUNE 3, 2024
Susan Wilcox Increasing regionalization due to: Growth of specialty centers Increasing development of healthcare systems Hub-and-spoke models Development of ECMO, trauma, transplant, and stroke centers The higher the acuity of the centers, the higher the acuity of the patient that needs to get there.
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.
Taming the SRU
SEPTEMBER 1, 2023
for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%
Sensible Medicine
JUNE 30, 2023
By the time she died, this management had included intravenous fluids, pain medications, antiemetics, and seizure medications. There was fatigue, weight loss, nausea, declining kidney function, and a few strokes. ” I documented those words in my progress note that day. She was in her late 70’s and she was dying.
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] MI or stroke).
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