Don't Forget the Bubbles

AUGUST 12, 2024

What neuroprotective measures can we undertake in the emergency department? Neuroprotective measures are undertaken in the emergency department and PICU to optimise intracerebral conditions, minimise secondary brain injury, and create optimal tissue healing conditions. Do we need seizure prophylaxis? J Neurotrauma.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Taming the SRU

JANUARY 12, 2024

pediatric small groups WITH our cchmc colleagues Dermatologic emergencies Children can present with a wide range of rashes, many of which are benign, however identifying concerning rashes is very important. Use your resources to differentiate scary from benign! Children are not just small adults!

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. doi: 10.1542/pir.2014-0122.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

EMDocs

JANUARY 17, 2024

She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9) 9) In 2019, benzonatate accounted for ~ 10% of all pediatric antitussive prescriptions dispensed via retail pharmacies. (9)

Poisoning 67

Poisoning Seizures Pediatrics EMS 67

EMDocs

NOVEMBER 19, 2024

1 Seizures may occur due to lowered seizure threshold. 6 Seizures have been observed and are dose-dependent. 1 Benzodiazepines are preferred as the first line of treatment for agitation or seizures. Low-dose lipid emulsion for pediatric vasoplegic shock due to quetiapine and fluvoxamine overdose: a case report.

Poisoning 74

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 74

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. When should the emergency physician obtain lab tests to medically clear such patients?

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

EMDocs

JUNE 9, 2023

If you have restraints in your ambulance, are those restraints appropriately sized for pediatric patients? If pharmacologic or physical restraints are used, it is very helpful to notify the receiving emergency department prior to arrival so they can be prepared.

EMS 76

EMS Documentation/Coding Pediatrics Psychiatric 76

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

JUNE 7, 2023

mg/kg pediatrics) Double dose every 5 min Titrate up to end point of therapy and may require very large doses Target End Point of Therapy = clear chest sounds, HR > 80/min, pupil size greater than pinpoint, and dry axillae. Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. See figure below.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Case: You are working night shift in the emergency department.

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

Taming the SRU

MAY 1, 2023

A retrospective evaluation of phenobarbital versus benzodiazepines for the treatment of alcohol withdrawal in a regional Canadian emergency department Link: [link] Bottom Line: This study in a small regional ED showed a QI project rolling out a Phenobarbital or Diazepam for Alchohol withdrawal syndrome.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

EMDocs

JULY 30, 2024

Shortly after this, he began vomiting, and developed a tonic clonic seizure. There was no prodromal illness, recent trauma, polyuria or polydipsia, family history of seizure disorder or diabetes. Case Follow-up: The patient was admitted to the pediatric intensive care unit. Clinical Pediatrics. Elsevier; 2010:2153-2217.

Poisoning 56

Poisoning Seizures Fluid Resuscitation Pediatrics 56

Taming the SRU

FEBRUARY 23, 2024

Consider starting more goals of care discussions in the emergency department, not just for patients who are actively dying. There are several guidelines outlining when to obtain a CT head prior to LP (but all agree that if suspecting acute bacterial meningitis you should empirically treat if delaying LP for CT).

Pediatrics 74

Pediatrics Ultrasounds Fractures Wellness 74

PEMBlog

OCTOBER 2, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. Topics covered include: The pathophysiology of GER and GERD in the pediatric population. J Pediatr Gastroenterol Nutr. Pediatrics.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

PEMBlog

MAY 9, 2024

Febrile Seizures are among the most common neurological problema in young children, occurring in 1 out of 50 children between the ages of 6 months and 5 years of age. Febrile Seizure. Common variants associated with general and MMR vaccine-related febrile seizures. Ann Emerg Med. Ann Emerg Med. Pediatrics.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

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. corneal toxicity secondary to latex from Asclepias curassavica in a pediatric patient. J Chem Ecol. 2019;45(1):50-60. Yang JF, Beal CJ.

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

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. cuffed ETT) preloaded and intubate through the stoma if PPV needed Infection (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

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., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S.,

Psychiatric 88

Psychiatric Seizures Emergency Department Pediatrics 88

Advanced Emergency Nursing from AENJ

NOVEMBER 7, 2015

Even as a Paramedic, in the early days, there was no analgesia, sedative (except for seizures), or anesthetic, to provide. In my opinion, hypnosis is a little-understood but potentially valuable technique for the emergency department. Why isn't hypnosis used more in emergency departments? PMCID: PMC2417820.

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? A fundamental tenet of emergency medicine: We balance our obligation to detect a dangerous condition with our suspicion of the disease in given patient. Cohen et al. Cohen et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. A 2023 Quality Improvement (QI) project involved the introduction of a medical clearance algorithm for children presenting with psychiatric emergencies. Hosp Pediatr. Pediatrics. Acad Emerg Med.

Psychiatric 119

Psychiatric Sexual Assault Emergency Department Pediatrics 119

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.

Seizures 66

Seizures EKG/ECG Poisoning Shock 66

ACEP Now

MAY 10, 2024

A 9-month-old male presents to emergency department (ED) with his mother for seizure. The child was diagnosed with seizure disorder at 2 months of age and has had multiple visits to the emergency department (ED) for seizures. Pediatric Emergency Care. Immunizations are up to date.

Forensics 98

Forensics Psychiatric Seizures Pediatrics 98

Taming the SRU

SEPTEMBER 1, 2023

Can also extend this logic to those with TBI’s or trauma patients are inebriated Can attempt try to mitigate the risk and harm associated with iWBCT’s Future use of low-dose iWBCT Full-body MR imaging is already being used in pediatric patients Logistic regression in REACT-2 patient population identified 10 characteristics to warrant iWBCT in patients (..)

Sepsis 95

Sepsis Documentation/Coding Administration Fractures 95

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

HELLP Syndrome [pdf] Sara Paul MD Intrauterine Fetal Demise [ppt] Irene Hwang, MD Obesity in Pregnancy [pdf] Rafael Garabis, MD Seizures in Pregnancy [ppt] Sherifia Heron , MD Substance Abuse in Pregnancy [ppt] Sophia Y. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Downeast Emergency Medicine

MARCH 24, 2021

OVERVIEW Diarrhea is a common complaint for our pediatric patients in the emergency department. Most pediatric diarrhea is not life threatening, and usually is treated with supportive care. However, there are important red flags to consider when assessing a pediatric patient with diarrhea.

Pediatrics 52

Pediatrics Dehydration Emergency Department Wellness 52

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

Act V, scene I [Text from Folger Shakespeare Library] [Audio recording of Dramatic Reading; Chapter Vox] [Video recording of Act V, scene1] Most deaths that are brought to, or occur in, an emergency department will require, at least, discussion with the local Coroner or Medical Examiner. No "practice procedures" should be done.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

ACEP Now

OCTOBER 29, 2024

Initial echocardiogram (ECG) on arrival (see figure 2) to our emergency department revealed normal sinus rhythm, mild interventricular conduction delay (RSR’), and possible right ventricular hypertrophy. Pediatric cardiology was consulted. Dr. Lacey is a pediatric cardiologist at Children’s National Hospital, Washington D.C.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2016

in Pediatrics reported on children with headache suspected of having a brain tumor. in Pediatrics did a systematic review of Clinical Features Suggestive of Meningitis in Children. Headache plus… a new seizure. A comparison of acute treatment regimens for migraine in the emergency department. Pediatrics.

Pediatrics 52

Pediatrics Emergency Department Seizures Wellness 52

Don't Forget the Bubbles

JULY 5, 2023

Do not use pethidine since it can cause seizures and CNS hyperexcitability. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. Pediatr Allergy, Immunol Pulmonol 2017; 30: 191–201. Alternatives to morphine are hydromorphone or fentanyl. Anemia ; 2015.DOI:10.1155/2015/791498.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

PEMBlog

JULY 10, 2024

” Emily Labudde, MD, a Pediatric Emergency Medicine fellow at Children’s Healthcare of Atlanta and recent pediatric residency graduate from Cincinnati Children’s discusses the various manifestations of this sexually transmitted infection, and how we can’t miss this very treatable, but sneaky malady. .”

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

Taming the SRU

JUNE 6, 2023

HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5 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

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Later in the pediatric intensive care unit (PICU), he developed pulmonary edema, but he continued to improve neurologically. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education.

Seizures 52

Seizures EKG/ECG CPR Shock 52

EMDocs

NOVEMBER 4, 2024

Headache red-flag characteristics include neurological symptoms, thunderclap nature, syncope, trauma, immunocompromised, coagulopathy, fever, rash, seizure, nuchal rigidity, altered mental status, pregnancy, temporal tenderness, jaw claudication, and cancer history. J Emerg Med. Acad Emerg Med. J Emerg Med. Ann Emerg Med.

Emergency Department 98

Emergency Department Fractures Burns EMS 98

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. Among children, hypoglycemia is common and can lead to seizures. Pediatr Infect Dis J.

Dehydration 89

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 89