Dr. Smith's ECG Blog

DECEMBER 26, 2020

Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. The case was reviewed by the receiving team who had concerns for acute stroke or other cause of acute altered mental status. Serial troponins were negative.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

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

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 Seizures 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. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. Cohen et al. Later, Maher et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

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. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

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. The patient is in no acute distress.

Seizures 98

Seizures Stroke Outcomes EMS 98

EMDocs

DECEMBER 16, 2023

As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. An 18-month-old boy presents to the emergency department with loss of consciousness. Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. C, and heat stroke occurs at a core temperature > 40°C.

Hyperthermia / Hypothermia 96

Hyperthermia / Hypothermia EMS Stroke Seizures 96

EB Medicine

FEBRUARY 1, 2019

This month, we’re tackling an incredibly important topic - evaluation and management of life threatening headaches in the Emergency Department. Nachi: And patients with neurologic deficits or severe sudden-onset headaches, should be transported immediately to the nearest available stroke center. That’s quite a list.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

The Skeptics' Guide to EM

APRIL 9, 2022

AEM April 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM April 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: April 7th, 2022 Reference: Wong et al.

Head Injuries 52

Head Injuries Emergency Department Seizures Stroke 52

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

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%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

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. Cephalalgia.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. Do not use pethidine since it can cause seizures and CNS hyperexcitability. What is the role of transcranial dopplers in primary prevention of strokes?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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

Taming the SRU

NOVEMBER 18, 2024

This blog post will attempt to serve as a resource to assist in the evaluation of persistent/intractable hiccups and cover the physiology, classification, associated disease processes, evaluation and management strategies of hiccups in the emergency department.

Stroke 86

Stroke Administration COPD Dehydration 86

ACEP Now

MARCH 10, 2025

You follow the recommended emergency department (ED) lab workup for hypertensive disorders of pregnancy, including urine protein/creatinine ratio, serum creatinine, platelet count, complete blood count, and renal liver function tests. Antihypertensive treatment is the priority, followed by magnesium treatment for seizure prevention.

OB/GYN 52

OB/GYN Seizures Stroke Hospitals 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. 2024.01.007.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

EMDocs

FEBRUARY 3, 2025

These complications affect both the central and peripheral nervous systems and encompass a wide range of conditions, including transient ischemic attacks (TIA), stroke, headaches, mood disorders, seizures, psychosis, neuropathy, and cognitive dysfunction (1,6,7).

Stroke 71

Stroke EMS Seizures Outcomes 71

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. HIV Prevention and Treatment: The Evolving Role of the Emergency Department.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75