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Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.
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.
3-6 Clinical Presentation: Symptoms include altered mental status, tachycardia, hyperthermia, urinary retention, mydriasis, blurred vision, dry skin, hallucinations. Anticholinergic toxicity has overlap with other toxicological causes of hyperthermia which are reviewed here: Hyperthermia in the Toxicological Setting.
We have previously discussed hypothermia presentations , GBS infections , and HSV infections. The post Congenital Syphilis appeared first on Pediatric EM Morsels. Fortunately, we have addressed many neonatal issues in the PedEMMorsels. Obviously, one of the most concerning considerations in neonates is the potential for infection.
Hypothermia for Neuroprotection in Convulsive Status Epilepticus. Case: Johnny is a […] The post SGEM#199: Therapeutic Hypothermia – What is it Good For? Hypothermia for Neuroprotection in Convulsive Status Epilepticus. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure.
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. Before EMS arrived, she had "seizure activity" and became unresponsive. She underwent therapeutic hypothermia, and emerged from coma. She was intubated.
Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. The guidelines also address issues related to EMS provider skill level, transportation modality, and destination for the patient.
PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. Bottom line: Although this RCT demonstrates a 7 day mortality benefit of using ketamine over etomidate, the level of certainty in the results is low.
EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75 Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.
Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. The rhabdo is believed to be due, in part, to associated seizures, muscle tremors, and agitation. Are we still reviewing talking points together before we start recording these episodes?
We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure.
Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. EMS reported an initial GCS of 8 with pupils equal and reactive. The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. Is this takotsubo?
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.
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. A review of systems is notable for nausea and vomiting but no diarrhea.
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