The Skeptics' Guide to EM

DECEMBER 15, 2018

Acetaminophen and febrile seizure recurrences during the same fever episode. He specialises in Paediatric Emergency Medicine and is a passionate […] The post SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen? first appeared on The Skeptics Guide to Emergency Medicine. Pediatrics. Pediatrics.

Seizures 52

Seizures Pediatrics Emergency Department Outcomes 52

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. We have previously discussed an approach to the question of when a patient “ can return to sport.”

Seizures 243

Seizures Pediatrics Academics Emergency Department 243

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

Emergency Department 152

Emergency Department Hyperthermia / Hypothermia Seizures Pediatrics 152

EMDocs

MAY 25, 2023

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 mg/kg or 10 mg Intravenous lorazepam 0.1

Seizures 63

Seizures Administration Anaphylaxis Outcomes 63

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.

Seizures 72

Seizures Documentation/Coding EKG/ECG Emergency Department 72

The Skeptics' Guide to EM

MAY 25, 2024

Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Reference: Borgundvaag et al. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.

Emergency Department 77

Emergency Department Best Practices Seizures Research 77

Taming the SRU

MARCH 30, 2024

Visiting lecturer: structural leadership - taming the sru - r4 sim and oral boards “Innovation Meets the Bedside: The Evolution of New Models of Emergency Care Delivery” WITH dr. ben bassin “What problem are you trying to solve?”

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 88

EMergucate

MAY 22, 2023

An alcoholic man presented to the emergency department after suffering from a seizure. His venous blood gases showed the following: … Continue reading →

Seizures 40

Seizures Emergency Department 40

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. Acetaminophen, NSAIDs, and antiemetics are all reasonable choices.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

EMergucate

JULY 11, 2022

53 years old type I diabetic lady was brought to the emergency department with tiredness, Blood gases were taken in ED. While awaiting the results of these gases the patient had a seizure. The bloo…

Seizures 40

Seizures Emergency Department 40

EB Medicine

JUNE 1, 2021

EMplify - June 2021 Announcements: The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual. Cardiac Differentiating syncope from seizure Features that point to seizure Urinary incontinence Number of jerks Age? Etiology: figure 1 is fantastic. What do paramedics see? Any trauma?

Seizures 52

Seizures Emergency Department EKG/ECG Hospitals 52

Don't Forget the Bubbles

SEPTEMBER 13, 2023

Do not order laboratory testing or a CT scan of the head for a patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status. The parents of 18-month-old Susie brought her to the Emergency Department after she had a seizure at home.

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

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

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., As may be seen in the table below, there are several themes as well a range of stringency.

Infectious Diseases 90

Infectious Diseases Seizures Ultrasounds Sepsis 90

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast. But now I’m going to pass the mic.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance.

Seizures 85

Seizures Stroke Outcomes EMS 85

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

Emergency Department 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

The Skeptics' Guide to EM

APRIL 10, 2021

He is a GP by training but works in Emergency Department, Anaesthesia, Internal Medicine and Paediatrics. He has a wonderful #FOAMed blog and podcast called Broomedocs and also work […] The post SGEM#326: The SALSA Study: Hypertonic Saline to Treat Hyponatremia first appeared on The Skeptics Guide to Emergency Medicine.

Seizures 52

Seizures Emergency Department 52

EMDocs

JANUARY 17, 2024

She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). Benzodiazepines are first-line therapy for seizures. She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). 11) A bolus dose at 1.5

Poisoning 67

Poisoning Seizures Pediatrics EMS 67

EMDocs

JUNE 7, 2023

Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Case Follow-up: The patient required benzodiazepine administration for seizure management and subsequent intubation for airway protection. Parenteral organophosphorus poisoning in a rural emergency department: a case report.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. CPVT is a difficult diagnosis to make during a routine clinic visit and can be easily misdiagnosed as vasovagal syncope or a seizure disorder. Find him on Twitter @HagahmedMD The Pre-brief An 11 y/o boy suddenly collapses at a sporting event.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. Open Access Emerg Med. 2012.07.056.

Administration 98

Administration Emergency Department Seizures Hospitals 98

EMDocs

JUNE 14, 2023

Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Parenteral organophosphorus poisoning in a rural emergency department: a case report. He has been having difficulty walking and is having trouble manipulating tools he uses for work with his hands. link] Updated September 14, 2020.

PPE 70

PPE Poisoning Seizures Emergency Department 70

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. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

EMDocs

FEBRUARY 15, 2024

8 However, it is not considered first line in treatment of anticholinergic toxicity and is not available in all emergency departments. Physostigmine does not reverse seizures or dysrhythmias. Physostigmine does not reverse seizures or dysrhythmias. 9 Physostigmine dosing: 0.5-2 mg; for children, can use 0.02

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Poisoning Seizures COPD 89

PEMBlog

SEPTEMBER 6, 2023

In fact, some Emergency Departments note that as many as one tenth of their patient volume is mental health. Medical clearance’ of patients with acute mental health needs in the emergency department: a literature review and practice recommendations. Ann Emerg Med. Ann Emerg Med. Health Aff (Millwood).

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

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

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. The father reported the patient was in his usual state of health approximately two hours ago.

Poisoning 56

Poisoning Seizures Fluid Resuscitation Pediatrics 56

PulmCCM

OCTOBER 23, 2023

Cefepime crosses the blood-brain barrier, and dozens of case reports have associated the drug with seizures, encephalopathy, delirium, and coma, with a possibly increased incidence of neurologic adverse effects among patients with renal failure or sepsis. Paxlovid also did not reduce symptoms of Covid-19 in that trial.

Hospitals 98

Hospitals Emergency Department COPD CDC 98

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

She is interested in social determinants of health in the emergency department and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

ALiEM

DECEMBER 4, 2023

A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. The patient was recently admitted to the hospital eight days prior to presentation for purulent urethral discharge where he received a course of topical antibiotics and was discharged.

Academics 60

Academics Seizures Hospitals Emergency Department 60

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 Outcomes Seizures 59

Broome Docs

OCTOBER 31, 2022

Safety and efficacy of prophylactic levetiracetam for prevention of epileptic seizures in the acute phase of intracerebral haemorrhage (PEACH): a randomised, double-blind, placebo-controlled, phase 3 trial. Emerg Med J. The PEACH trial: No body had a fit, so… we have no clue Peter-Derex L, Philippeau F, Garnier P, et al.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. 1 In severe cases altered mental status, seizures, coma, or even death have been observed. She reported that these symptoms started two days prior, shortly after consuming a fruit known as ackee.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 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

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. Consider alternative pathways that can facilitate a quicker disposition such as utilizing CCTAs for chest pain patients. The intensity of the care plan while inpatient tends to follow that started in the ED.

Pediatrics 70

Pediatrics Ultrasounds Fractures Wellness 70