Taming the SRU

SEPTEMBER 24, 2023

Patients with a history of seizures, supratentorial structural brain pathologies, post-arrest, or unexplained altered mental status should prompt suspicion for NCSE. However, Ceribell is a useful technology to help detect seizure activity and affect disposition. Two main theories behind the development of PRES. (1)

Seizures 52

Seizures EKG/ECG Emergency Department Shock 52

Dr. Smith's ECG Blog

JULY 14, 2010

Before EMS arrived, she had "seizure activity" and became unresponsive. She arrived comatose and in cardiogenic shock and the following ECG was recorded. A 56 yo f with h/o HTN and hypercholesterolemia called EMS from home after onset of L chest pain radiating to the left arm. She was intubated.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Seizures EKG/ECG EMS 52

Ken Grauer, MD

MAY 31, 2024

I was sent the ECG in Figure-1 — without the benefit of any history. Figure-1: I was sent this ECG without any history. MY Thoughts on Today’s CASE: As tempting as it might be to reach for the defibrillator on seeing the ECG shown in Figure-1 — My initial reaction was different. No shock was needed. Is this VT?

Shock 411

Shock EKG/ECG Seizures 411

Dr. Smith's ECG Blog

AUGUST 13, 2020

Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. Then I looked into the patient's chart and found an old EKG: This shows a previous QR-wave in V2, diagnostic of old anterior MI. I wrote back: "I am looking at his old EKG. Cardiology came to assess the patient.

EKG/ECG 52

EKG/ECG Shock Stroke Seizures 52

Taming the SRU

JANUARY 26, 2024

Yates Case 1: Stroke and Stroke Mimics Early diagnosis of stroke improves stroke outcomes, where misdiagnosis is associated with an upwards of 4-time higher likelihood of mortality Missed strokes most often occur with atypical symptoms, in younger aged patients, those with posterior strokes, and those with lower NIH scores It can be difficult to discern (..)

Stroke 59

Stroke EKG/ECG Seizures Outcomes 59

EMDocs

NOVEMBER 1, 2023

1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). upper endoscopy, transesophageal echo, etc.). Abdomen: Evidence of peritonitis if intra-abdominal rupture.

Operations 78

Operations Radiology Radiology Fluid Resuscitation 78

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Taming the SRU

MAY 1, 2023

Patients must have EKG findings and meet one of a few other criteria (ie family history of sudden death, VF or VT episode, syncope, nocturnal agonal respirations) Most common in patients of Southeast Asian descent and the mean age of death from arrhythmia if untreated is in the 4th decade of life.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Mind The Bleep

OCTOBER 29, 2024

Circulation Assess heart rate, blood pressure, peripheral and central CRT, pulses and 3 lead ECG. Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11].

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Pediatric Emergency Playbook

JUNE 1, 2017

Electrocardiography (ECG) should be performed on any patient with significant blunt chest injury. A negative ECG is highly consistent with no significant blunt myocardial injury. Any patient with a new abnormality on ECG (dysrhythmia, heart block, or signs of ischemia) should be admitted for continuous ECG monitoring.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EMDocs

NOVEMBER 19, 2024

1 Seizures may occur due to lowered seizure threshold. 6 Seizures have been observed and are dose-dependent. Recommend obtaining multiple EKGs to aid in the diagnosis of cardiotoxic effects such as dysrhythmias or interval widening, even if not apparent immediately after the overdose. 8 Hypersalivation can occur.

Poisoning 102

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 102

EMDocs

JANUARY 4, 2024

Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 Severe toxicity: Seizures: It is unclear if seizures are caused by bupropion or the active metabolite, hydroxybupropion. 3 Seizures are dose-dependent. 3 Seizures are dose-dependent. EMIT II immunoassay).

Seizures 77

Seizures EKG/ECG Poisoning Shock 77

Dr. Smith's ECG Blog

MARCH 11, 2012

A young man presented after a prolonged seizure. Here was his initial ECG: Regular Wide Complex Tachycardia. Here is the same ECG with some annotation (lines): The first line is drawn at the onset of the QRS in V2, which is clear. The clinicians shocked the patient at 200 J x 2, with no change. He was intubated.

Seizures 52

Seizures Shock EKG/ECG Outcomes 52

Dr. Smith's ECG Blog

JUNE 26, 2023

Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). As I discuss in detail in My Comment at the bottom of the page in the May 24, 2020 post in Dr. Smith's ECG Blog — AV dissociation is not the same as AV block. How would YOU interpret this tracing?

EKG/ECG 97

EKG/ECG Seizures Sepsis Operations 97

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 88

Psychiatric Seizures Emergency Department Pediatrics 88

Dr. Smith's ECG Blog

OCTOBER 7, 2019

This is by one of our outstanding 3rd year residents , Aaron Robinson, with some edits and comments by Smith EMS responded to a reported seizure in a 42 year old male. He reports no personal or familial history of seizures. When the physicians approached him, he was ashen, diaphoretic, and appeared in shock.

Seizures 40

Seizures EKG/ECG Shock EMS 40

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Paramedics continued chest compressions, gave epinephrine via an intraosseous route, and delivered one shock. The first prehospital EKG showed Polymorphic Ventricular Tachycardia (PVT) that responded to defibrillation.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

As part of the workup, she underwent an ECG. 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. We repeated the ECG: Brugada pattern is mostly resolved. Is this Type 2 Brugada syndrome/ECG pattern?

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Emerg Med Pract.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia EMS Stroke Seizures 80

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 The rhabdo is believed to be due, in part, to associated seizures, muscle tremors, and agitation. Symptoms here include irritability, anxiety, restlessness, sleep difficulty, seizures, and aggression.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40