ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. According to family at the scene, he has a history of seizures but has not been taking his medication recently. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. Clinical Question » How should status epilepticus be diagnosed?

Seizures 52

Seizures Emergency Department Outcomes EMS 52

EMDocs

JUNE 9, 2023

After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children. That includes the patient, EMS personnel, and general public.

EMS 97

EMS Documentation/Coding Pediatrics Psychiatric 97

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) A systematic review of safety data for over 16000 pediatric patients did show MAEs were the most frequently reported event. 451 pediatric patients were included. From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. Pediatrics.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Pediatric EM Morsels

APRIL 7, 2023

There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Expert Rev Hematol. doi: 10.1586/ehm.13.25.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

EMDocs

AUGUST 3, 2023

Massive acetylcysteine overdose associated with cerebral edema and seizures. Pediatr Emerg Care. link] Heard K, Schaeffer TH. Clin Toxicol (Phila). 2011 Jun;49(5):423-5. doi: 10.3109/15563650.2011.583664. PMID: 21740141. Brush DE, Boyer EW. Intravenous N-acetylcysteine for children. 2004;20(9):649-650. doi:10.1097/01.pec.0000139754.56001.90

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

RebelEM

JULY 10, 2024

Red flags in patients with headaches that may suggest a brain tumor include signs of increased intracranial pressure, focal neurological signs, seizures or ataxia. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 126.0 – Peds Hem Onc Emergencies appeared first on REBEL EM - Emergency Medicine Blog.

Seizures 58

Seizures Administration EMS Wellness 58

ACEP Now

JUNE 14, 2024

And the Board approved a new clinical policy, “Critical Issues in the Management of Adult Patients Presenting to the ED with Seizures,” rescinding the 2014 clinical policy with same title. Open applications will be coming soon, but you can find out more and get on the interest list today at acep.org/EDap.

Sexual Assault 52

Sexual Assault Seizures Documentation/Coding EMS 52

Taming the SRU

FEBRUARY 5, 2024

For pediatric patients, we recommend using the PECARN Pediatric Head Injury Algorithm. Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2]. JAMA Pediatr. For high-risk patients, a non-contrast CT Head is the test of choice. JAMA Netw Open.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

SheMD

JULY 6, 2023

When I told my EM preceptor I was interested in OB, they made sure I did every OB US/pelvic exam required that day. When you attend 7-8 clerkships simultaneously, you can’t check off pediatrics and forget the immunization schedule ever existed! Study for board exams: The LIC model was built for board exams.

Ultrasounds 52

Ultrasounds Research Seizures Pediatrics 52

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

Meanwhile, the patient has just returned from a scan and had a seizure in front of you because his brain is speckled with contrast; post-ictus, he's apneic despite airway measures, and now one must give mouth-to-mouth because there's no bag at the bedside … see what I mean? Disposable BVMs (one at every bedside).

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

Pediatric EM Morsels

NOVEMBER 3, 2023

ovale to cover the hypnozoite that can stay dormant in the liver and cause a secondary infection in the future Severe Malaria IV artesunate is currently the accepted first line treatment Previously IV quinine was first line, however it was associated with higher incidence of hypoglycemia, cardiac dysrhythmias, seizures, and comas.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). McGraw Hill; 2019.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Pediatric EM Morsels

MAY 10, 2024

Add the risk assessment for sudden cardiac death into your workflow Have you ever fainted or had a seizure without warning, during exercise or in response to a loud noise? Regional implementation of a pediatric cardiology chest pain guideline using SCAMPs methodology. Pediatrics. Pediatrics. Pediatr Clin North Am.

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EKG/ECG Pediatrics Ultrasounds Seizures 271

ACEP Now

OCTOBER 3, 2023

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.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

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 91

Seizures EKG/ECG Poisoning Shock 91

EMDocs

JANUARY 17, 2024

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. 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 88

Poisoning Seizures Pediatrics EMS 88

Pediatric EM Morsels

AUGUST 9, 2024

The post Congenital Syphilis appeared first on Pediatric EM Morsels. Pemphigus syphiliticus Hepatomegaly Most common May have abnormal LFTs and evidence of Hepatitis. Jaundice Lymphadenopathy Generalized Epitrochlear lymphadenopathy is suggestive of congenital syphilis. A case of congenital syphilis. Emerg Radiol. Epub 2013 Feb 27.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

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 74

Poisoning Seizures Fluid Resuscitation Pediatrics 74

PEMBlog

MARCH 27, 2024

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. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. Upon EMS arrival, the patient was in cardiac arrest. EMS shows you the prescription bottle with a handful of capsules remaining. Seizures should be treated with benzodiazepines. J Pediatr Pharmacol Ther. 28 June 2019.

Seizures 52

Seizures Poisoning Resuscitation Administration 52

Taming the SRU

FEBRUARY 23, 2024

Clinical pathologic case presentation - r1 diagnostics/therapeutics: Lumbar punctures - AIRWAY GROUND ROUNDS- r4 capstone - r3 taming the sru - ultrasound grand rounds Clinical pathologic case presentation WITH Drs.

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

Taming the SRU

MARCH 14, 2023

Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. The seizure abated with rectal diazepam given by the squad. You notice a med-alert bracelet with the patient’s name and the word “SEIZURES.” Pediatr Emerg Care. 88, 1327-1344.e2.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

MAY 1, 2023

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.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Taming the SRU

MAY 30, 2023

Comiskey Hyperammonemia 10% of of patient presenting with hepatic encephalopathy do not have elevated ammonias Most commonly seen in adults is secondary to liver dysfunction with cirrhosis or portal venous system shunting. billion passengers annually 1 medical emergency per 604 flights Most common complaints: Syncope/presyncope: 37.4%

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Also, just a quick FYI - If you’re not a current subscriber to Pediatric Emergency Medicine Practice, we’re giving away a free copy of the issue specifically for our listeners.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

ACEP Now

MARCH 11, 2025

A survey that looked at 637 residency programs including pediatric, family, and internal medicine in 2014 found that only 42 programs offered formal training in eating disorders. A special thanks to Dr. Samantha Martin and Dr. Jennifer Tomlin for their expertise in the EM Cases podcast that inspired this column. Pediatrics.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. 2017.04.011 Witt CE, Bulger EM. Authors: Nikhil B.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

Critical Care Now

JUNE 21, 2022

Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. His coach and fellow players witnessed a seizure-like activity immediately after collapsing. His coach and fellow players witnessed a seizure-like activity immediately after collapsing. A cardiac MRI was unremarkable.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Pediatric EM Morsels

MARCH 7, 2025

Let’s take a moment to review TXA (Tranexamic Acid) in Pediatrics! Wouldnt it be nice if there were adjuncts to prevent further bleeding or add benefit when blood may not be option (prehospital)? Enter TXA or tranexamic acid , The Clot Stabilizer!Let’s mg/kg [Nishijima 2016] Poorly studied in renally impaired patients.

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Pediatrics Blood Transfusions Anaphylaxis Military 231

Pediatric EM Morsels

NOVEMBER 15, 2024

Seizures are super scary for a parent to witness, but not all seizures mean danger. There is actually a diagnosis of seizures that has “ BENIGN” in the name! We have even talked about using a ketogenic diet to control seizures , and seizure mimics.

Seizures 154

Seizures Stroke Pediatrics Wellness 154

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. In the US 95% of vaccine-eligible pediatric patients who travel are unvaccinated (McAteer 2021) Drug resistance has been developing over time. In addition to my passion for PEM, I also share a passion for global health.

Pediatrics 164

Pediatrics CDC Seizures Documentation/Coding 164

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 98

Poisoning Airway Management Seizures PPE 98

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 65

Documentation/Coding Seizures Psychiatric Wellness 65

EMDocs

MARCH 11, 2024

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Among children, hypoglycemia is common and can lead to seizures. Pediatr Infect Dis J. 2013;8(1):e54395. doi:10.1371/journal.pone.0054395 2006;25(12):1163-1166. doi:10.1097/01.inf.0000246977.58697.a5

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

ACEP Now

OCTOBER 29, 2024

EMS found the patient pulseless and apneic, with an initial rhythm showing ventricular fibrillation (see figure 1). Figure 1: The EMS rhythm strip. Pediatric cardiology was consulted. 3-6 Additional features include first-degree atrioventricular block, atrial arrhythmias, nocturnal agonal breathing, and seizures.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 52

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. BMC Pediatr. A review of systems is notable for nausea and vomiting but no diarrhea.

Infectious Diseases 74

Infectious Diseases CDC PPE Rapid Diagnostic Testing 74