EMDocs

MARCH 2, 2024

We’ll keep it short, while you keep that EM brain sharp. Seizure as Early Presentation of a Pneumocephalus after Cochlear Implant: A Case Report. J The post EM@3AM: Pneumocephalus appeared first on emDOCs.net - Emergency Medicine Education.  2022 Mar;18(2):253-255. Palacios-García JM, Vazquez-Becerra E, Ropero-Romero F.

EMS 119

EMS Fractures Seizures Head Injuries 119

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. vivax or P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

ACEP Now

FEBRUARY 18, 2025

Emergency medical services (EMS) were called to the home of a 22-year-old woman after a syncopal episode and seizure-like activity. On EMS arrival, the patient was alert, pulse was fluctuating between 40 and 130 beats/min, and manual systolic blood pressure was 60 mmHg.

EKG/ECG 52

EKG/ECG Seizures Emergency Department EMS 52

RebelEM

SEPTEMBER 7, 2023

Levetiracetam is frequently used to prevent seizures in patients with conditions such as ICH, traumatic brain injury (TBI), supratentorial neurosurgery, and subarachnoid hemorrhage (SAH). About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ). Article : Peter-Derex et al.

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Seizures Stroke Outcomes Research 129

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? doi:10.1186/s13089-021-00205-x The post Chest Pain in Children: ReBaked Morsel appeared first on Pediatric EM Morsels. Ultrasound J. 2021;13(1):2.

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EKG/ECG Pediatrics Ultrasounds Seizures 271

Pediatric EM Morsels

AUGUST 23, 2024

The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898. PMID: 37316210.

Seizures 281

Seizures Pediatrics Academics Emergency Department 281

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

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 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

Emergency Medicine Cases

JUNE 19, 2018

In this EM Cases CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, a middle aged woman presents to a rural ED with headache and vomiting, normal vital signs with subsequent status epilepticus and serum sodium of 110 mmol/L.

Seizures 52

Seizures Ambulance Services Airway Management EMS 52

EMDocs

MAY 9, 2024

The triage nurse records the event as a “seizure” lasting 7 minutes. His MDM says nothing about the patient’s seizure but does state that “there is an ongoing community outbreak of gastroenteritis… and 6 patients currently in the ED with similar sx.” Plaintiff : You never acknowledged the alleged “7 minute” seizure.

Seizures 104

Seizures Dehydration Documentation/Coding Infectious Diseases 104

Emergency Medicine Cases

NOVEMBER 19, 2019

What is the essential list of immediate life threats with specific antidotes that we must know for the ED patient with a seizure? What are the key elements for distinguishing a true seizure from syncope? From Psychogenic Non-Epileptic Seizure (PNES)? Which patients who present with seizure require a CT head in the ED?

Seizures 52

Seizures Stroke EMS 52

EMDocs

APRIL 10, 2024

Authors: Alex Rogers, MD (EM Resident Physician, Christus Spohn/Texas A&M University School of Medicine, Corpus Christi, TX); J.D. She reportedly received a landmark guided peripheral nerve block with bupivacaine and shortly thereafter developed generalized seizures. 2,9] Benzodiazepines are the first line treatment for seizures.

Advances Cardiac Life Support (ACLS) 111

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 111

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. Patient seized for approximately 20 minutes prior to EMS arrival. On ED arrival GCS is 3, there are rapid eye movements to the right but no other apparent seizure activity.

Seizures 98

Seizures Documentation/Coding EKG/ECG Emergency Department 98

RebelEM

FEBRUARY 15, 2024

PMID: 38019968 Post Peer Reviewed By: Anand Swaminathan, MD (Twitter/X: @EMSwami ) The post The NICO Trial: NIV in Comatose Patients with Acute Poisoning appeared first on REBEL EM - Emergency Medicine Blog.

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Poisoning Airway Management Seizures Shock 141

RebelEM

JULY 26, 2023

Adenosine antagonism may lead to seizures and/or supraventricular tachycardia that is unresponsive to pushes of adenosine. Hemodialysis should also be considered in cases of refractory shock, dysrhythmias, or seizures. Eldridge 1989) Thus adenosine antagonism may lead seizures and/or status epilepticus. Exp Neurol. Read more

Seizures 97

Seizures COPD Shock EMS 97

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.

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EKG/ECG Seizures Stroke EMS 128

RebelEM

SEPTEMBER 27, 2023

If QRS >100 msec = 33% chance of seizures If QRS >160 msec = 50% of ventricular dysrhythmias Often extrapolated to other sodium channel blocking agents: diphenhydramine, loperamide, cocaine, lamotrigine, Type 1A/1C Anti-Dysrhythmics. As a result, it is essential to replete potassium simultaneously. N Engl J Med. PMID: 4022081.

Poisoning 104

Poisoning Seizures Administration EKG/ECG 104

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. 2013 Aug;20(4):337-9.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

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 98

EMS Documentation/Coding Pediatrics Psychiatric 98

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. Benzodiazepines are first-line therapy for seizures. Bishop-Freeman SC, Shonsey EM, Friederich LW, Beuhler MC, Winecker RE. There is no specific antidote for benzonatate. Am J Case Rep.

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Poisoning Seizures Pediatrics EMS 89

Emergency Medicine Cases

JULY 8, 2024

EM Cases is Free Open Access; please consider a donation to help ensure that EM Cases remains Free Open Access on our donation page [link] The post Ep 196 Pediatric Meningitis Recognition, Workup and Management appeared first on Emergency Medicine Cases. and many more.

Pediatrics 109

Pediatrics EMS Wellness Seizures 109

Dr. Smith's ECG Blog

OCTOBER 7, 2019

This is by one of our outstanding 3rd year residents , Aaron Robinson, with some edits and comments by Smith EMS responded to a reported seizure in a 42 year old male. He reports no personal or familial history of seizures. The physicians quickly recognized that this was not a seizure and likely cardiac in nature.

Seizures 40

Seizures EKG/ECG Shock EMS 40

Pediatric EM Morsels

APRIL 7, 2023

The post Sickle Cell Disease and Stroke appeared first on Pediatric EM Morsels. Observation, interaction with patient, as well as parent information is key to bring the whole picture together! Stroke in patients with sickle cell disease. Expert Rev Hematol. 2013 Jun;6(3):301-16. doi: 10.1586/ehm.13.25. PMID: 23782084.

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Stroke Pediatrics Seizures Sepsis 130

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 59

Seizures Administration EMS Wellness 59

Taming the SRU

MARCH 30, 2024

Emergency Critical Care Center (EC3) at the University of Michigan: Dedicated critical care unit within the emergency department that was created to improve access to timely, high-quality critical care after identifying a gap in emergency care delivery for patients Reduced risk-adjusted 30 day mortality among all ED patients, lower ICU admission rates (..)

Hyperthermia / Hypothermia 95

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 95

Dr. Smith's ECG Blog

DECEMBER 9, 2023

No chest pain, no shortness of breath, no back pain, no numbness, weakness, tingling, no seizures or history of seizures, First ED ECG This still shows apparent inferior OMI. Figure-1: The initial ECG in today's case — obtained by the EMS team. ( What do you think about cath lab activation? Why ECG #1 Looks Acute.

EKG/ECG 115

EKG/ECG Seizures Wellness EMS 115

EMDocs

DECEMBER 19, 2023

2020, September 26) EM@3AM: Marine Animal Bites and Stings. Possible early antibiotic treatment Minor Marine Trauma Mechanism: Bites, Stings, Nematocysts Envenomation Presentation: All can cause localized pain, erythema, and warmth Dermatologic: Urticaria, burning, pruritus, localized paresthesia. link] Blohm E, Brush D. Marine Envenomations.

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Poisoning Seizures Anaphylaxis Burns 105

EMDocs

FEBRUARY 15, 2024

Physostigmine does not reverse seizures or dysrhythmias. 7 Administer this antidote slowly via intravenous route over several minutes (5-10 minutes), as rapid administration is associated with seizures and bradycardia. Physostigmine does not reverse seizures or dysrhythmias. 9 Physostigmine dosing: 0.5-2

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Poisoning Seizures COPD 110

Emergency Medicine Cases

JULY 31, 2018

In anticipation of EM Cases Episode 113 Diagnosis an Workup of Pulmonary Embolism with Dr. Kerstin DeWit and Dr. Eddy Lang, we have Dr. Peter Reardon telling us his Best Case Ever (Coding in the Scanner) of a young woman who presents with a seizure followed by hemodynamic instability, who codes while in the CT scanner.

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Documentation/Coding Seizures EMS Resuscitation 52

Dr. Smith's ECG Blog

MAY 8, 2014

EMS was called by a roommate after the patient was noticed to be nonverbal and lethargic. His HR was 160 on arrival of EMS, and they gave him adenosine 6 mg and 12 mg and 500 cc NS, but with no response. Of 14 with initial QRS of 140 ms or longer, 8 (56%) had seizures. Sodium channel blockade in the CNS leads to seizures.

Seizures 52

Seizures EKG/ECG Administration EMS 52

EMDocs

AUGUST 28, 2023

A month later the child returns with seizures and altered mental status. link] Source : Thanks to attorney and EM attending Nicole Chicoine-Mooney, MD, JD for this case. The following morning the film is over-read, and a possible femur fracture is reported. He is left with significant disability and requires long term support.

Fractures 90

Fractures Seizures Patient Safety Hospitals 90

EB Medicine

MARCH 7, 2022

Why is this an important topic in EM? Treatment Hemorrhage Headache (CVT) Infection (mastitis, endometritis, wound Infection) Preeclampsia, eclampsia, HELLP, seizures Cardiomyopathy 12.What Why is this an important topic in EM? Hemorrhage etiologies and definition 3.Headache Fever and infection Mastitis Endometritis 5.Preeclampsia/eclampsia

Emergency Department 52

Emergency Department Seizures EMS EKG/ECG 52

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

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. Treatment: The mainstay of treatment is supportive care.

Seizures 52

Seizures Poisoning Resuscitation Administration 52

EMDocs

AUGUST 3, 2023

Massive acetylcysteine overdose associated with cerebral edema and seizures. In vitro analysis of N-Acetylcysteine (NAC) interference with the International Normalized Ratio (INR). Clinical Toxicology , 60 (4), 489–492. link] Heard K, Schaeffer TH. Clin Toxicol (Phila). 2011 Jun;49(5):423-5. doi: 10.3109/15563650.2011.583664. PMID: 21740141.

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

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 EMS 98

Dr. Smith's ECG Blog

JULY 14, 2010

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 was defibrillated successfully from ventricular fibrillation and developed a perfusing rhythm. She was intubated.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Seizures EKG/ECG EMS 52