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)? Well not exactly. The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. 2012.07.056.

Administration 98

Administration Emergency Department Seizures Hospitals 98

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

Dr. Smith's ECG Blog

OCTOBER 25, 2023

A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store. Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc. He did not have chest pain.

EKG/ECG 120

EKG/ECG Seizures Hospitals Stroke 120

EMDocs

NOVEMBER 19, 2024

1 Seizures may occur due to lowered seizure threshold. 1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. 6 Seizures have been observed and are dose-dependent.

Poisoning 90

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 90

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

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

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Consider intubation for patients with airway compromise, respiratory failure, altered mental status, or seizure. 5 Seizure: IV benzodiazepine first line, barbiturates as second line.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 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. He appears well and is triaged to an ESI 4. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

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

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

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. Or, well, the ringer called me.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

EMDocs

JUNE 14, 2023

This leads to an enhanced, as well as a prolonged predominant cholinergic effect. Used for treatment of acutely symptomatic anxiety, muscle fasciculations, and seizures. Parenteral organophosphorus poisoning in a rural emergency department: a case report. 1, 2 Sensory > Motor neurons with predilection for long axons.

PPE 70

PPE Poisoning Seizures Emergency Department 70

Taming the SRU

FEBRUARY 23, 2024

Total RBC count (<500 RBCs in last tube), as well as clearance by the last tube (decrease in RBC count by at least 70% by the last tube), can be used to differentiate between traumatic taps and a SAH. Consider starting more goals of care discussions in the emergency department, not just for patients who are actively dying.

Pediatrics 74

Pediatrics Ultrasounds Fractures Wellness 74

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

PEMBlog

SEPTEMBER 6, 2023

In fact, some Emergency Departments note that as many as one tenth of their patient volume is mental health. There is abundant evidence showing that routine lab tests in such patients have a very low yield and are not indicated, in adults as well as in children. Ann Emerg Med. Ann Emerg Med. Health Aff (Millwood).

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

EMDocs

SEPTEMBER 25, 2023

These clinically challenging intubations prompted emergency clinicians to turn to a KOBI technique and forgoing the use of an NMBA, which are not without risk. Additionally, many if not most emergency physicians do not receive adequate training on topical awake intubations (TAI) (11). Contraindicated seizures or porphyria.

Emergency Department 66

Emergency Department Soft Tissue Injuries Operations Airway Management 66

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. They called their transfer center cardiologist on call, who reviewed the case on the phone with them, as well as the ECG.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

Northwestern EM Blog

JANUARY 10, 2022

For those well-appearing neurologically intact hyponatremia patients w/ sodium levels > 120, further work-up & analysis of the underlying etiology can be deferred to the inpatient side. Hypertonic saline is not only indicated for seizures, coma, suspected cerebral herniation or focal neurological deficits as noted above.

Administration 52

Administration Seizures Emergency Department Wellness 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. Edits by Willy Frick.

EKG/ECG 67

EKG/ECG Wellness Point-of-Care Testing Shock 67

Taming the SRU

SEPTEMBER 1, 2023

Shewakramani Sepsis is associated with 20-40% mortality Screening tools for detecting patient at risk for sepsis in the ED SIRS Criteria (more sensitive tool) Temp <36C (96.8F) or >38C (100.4F) HR >90 RR >20 WBC <4k or >12k (or >10% bands) qSOFA Score GCS <15 RR >22 SBP <100mmHg Overall, SIRS Criteria remains (..)

Sepsis 95

Sepsis Documentation/Coding Fractures Administration 95

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? Erickson, M.D. (an

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

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. Franco is an emergency medicine attending physician at St.

Poisoning 40

Poisoning Administration Documentation/Coding Urgent Care 40

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. A non-contrast head computed tomography (CT) demonstrates a diffuse hyperdensity consistent with subarachnoid hemorrhage (SAH). His blood pressure (BP) is 220/120 mmHg.

Stroke 73

Stroke Outcomes EMS Seizures 73

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

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. 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

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries. J Opioid Manag. 2012 Jul-Aug;8(4):237-41.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

PEMBlog

OCTOBER 2, 2024

Children with respiratory conditions and chronic lung disease like asthma are more prone to GERD as well. This is sometimes misidentified as seizures. Now, in the pediatric emergency department, the diagnosis of reflux is primarily clinical. So, the parents may say, well, he Doesn’t ever seem full.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds 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

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. 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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Do not use pethidine since it can cause seizures and CNS hyperexcitability. In addition, free haem and haemoglobin contribute to the vascular damage.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. 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.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Taming the SRU

FEBRUARY 22, 2023

Team Environment Own the Resuscitative Real Estate Set up how you want the resuscitation to go Organize your space in the way that will wrok best for you and the patient Patient Special circumstances Peds Pregnant Mechanical circulatory support Update Partner Priorities Clear and well defined Lesson 2 Lead with kindness Being liked is a powerful tool (..)

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

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.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Early identification of patients at higher risk of death and hospital admission is an important problem in emergency departments. SEIZURE (FIT) 715 16 250 35 2.24[1.4 SOCIAL PROBLEM (MEDICALLY WELL) 58 1 27 46.6 0.018 , 0.12] INJURY OF HIP/LEG/KNEE/ANKLE/FOOT 7427 15 653 8.8 HEAD INJURY 3493 22 382 10.9

Documentation/Coding 40

Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 40

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

JANUARY 4, 2024

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. Bupropion lowers the seizure threshold and even at therapeutic doses patients can have seizures. 6 In one study, almost all patients who went on to develop seizures had tachycardia prior to the seizure.

Seizures 66

Seizures EKG/ECG Poisoning Shock 66

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., mg/kg (of 0.1

Psychiatric 88

Psychiatric Emergency Department Seizures Pediatrics 88