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 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

RebelEM

FEBRUARY 15, 2024

Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. 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.

Poisoning 139

Poisoning Airway Management Seizures Shock 139

Emergency Medicine Cases

JULY 8, 2024

How do the Canadian and American guidelines on work up of well-appearing febrile infants compare when to it comes to indications for lumbar puncture? We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages? and many more.

Pediatrics 109

Pediatrics EMS Wellness Seizures 109

Dr. Smith's ECG Blog

DECEMBER 9, 2023

Inferior Aneurysm morphology is incredibly hard to differentiate from Acute OMI, but you should suspect it whenever there are well-formed inferior Q-waves. 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.

EKG/ECG 116

EKG/ECG Seizures Wellness EMS 116

RebelEM

JULY 10, 2024

Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Red flags in patients with headaches that may suggest a brain tumor include signs of increased intracranial pressure, focal neurological signs, seizures or ataxia.

Seizures 58

Seizures Administration EMS Wellness 58

Pediatric EM Morsels

APRIL 7, 2023

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

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

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

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 86

Operations Radiology Radiology Fluid Resuscitation 86

Pediatric EM Morsels

AUGUST 18, 2023

Myth # 2: Neurologic affects Nervous system adverse events mostly include central concerns (ex, seizures, headaches, dizziness, lightheadedness, sleep disorders, hallucinations) and peripheral neuropathy. PMID: 29356761 The post Fluoroquinolone Use In Children appeared first on Pediatric EM Morsels. Pediatr Infect Dis J.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

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

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. There were some ACEP business decisions at the April Board meeting, as well. 17-23, 2025 in Orlando, Florida.

Sexual Assault 52

Sexual Assault Seizures Documentation/Coding EMS 52

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 91

Stroke Outcomes EMS Seizures 91

Taming the SRU

FEBRUARY 5, 2024

Several definitions have been set forth for this common injury, with perhaps the most well accepted definition being introduced by the Centers for Disease Control and World Health Organization. The history should focus on both the events surrounding the traumatic event, as well as current symptomatology.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

Case: It’s a busy night in the emergency department, your next patient is a well appearing 70-year-old man, presenting after a mechanical fall from standing with loss of consciousness. He is not on anticoagulation and there is no history of seizures. There are no other external signs of trauma on your exam.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

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. If assessing for SAH, xanthochromia may not appear until 12 hours after onset, though may appear after 2-4 hours.

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

RebelEM

NOVEMBER 16, 2022

Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 90.0 – Methemoglobinemia appeared first on REBEL EM - Emergency Medicine Blog. MetHb < 25% with symptoms Abnormal vital signs Metabolic acidosis End organ dysfunction (i.e. Goldfrank’s Toxicologic Emergencies, 9e New York, NY: McGraw-Hill; 2011.

Seizures 52

Seizures Administration Airway Management COPD 52

PEMBlog

MARCH 27, 2024

Or, well, the ringer called me. It is not the job or the expectation of the EM provider. They include neurologic dysfunction, which is one of the most common that includes things like developmental delay, regression, AKA loss of developmental milestones, hypotonia, encephalopathy, or seizures. And you’re thinking, hey!

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

Dr. Smith's ECG Blog

JUNE 17, 2016

He had a seizure this morning and rolled out of bed unable to get up. There were no injuries and no chest pain and he appeared well. The patient is a 36yo man who was seen for a seizure. Turns out that the patient regularly called EMS for complaints of chest pain that frequently led to cath lab activation.)

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

Taming the SRU

MARCH 14, 2023

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. 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.”

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

SEPTEMBER 25, 2023

They increase the risks of hypoxia and acidosis during the apneic period as well as hypotension and hypoperfusion caused by the abrupt transition from negative-pressure to positive-pressure ventilation (10). Contraindicated seizures or porphyria. Minimal histamine release. Cons: Short duration of action. Pain upon injection.

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

Dr. Smith's ECG Blog

FEBRUARY 4, 2023

He had a seizure this morning and rolled out of bed unable to get up. There were no injuries and no chest pain and he appeared well. The patient is a 36yo man who was seen for a seizure. Turns out that the patient regularly called EMS for complaints of chest pain that frequently led to cath lab activation.

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

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

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

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

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. How useful these would have been to let us know how well the patient was oxygenating and ventilating!

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

Taming the SRU

MAY 30, 2023

Smith Quick Facts regarding In-Flight Emergencies: 2.75 billion passengers annually 1 medical emergency per 604 flights Most common complaints: Syncope/presyncope: 37.4% Respiratory symptoms: 12.1% Nausea and vomiting: 9.5% Diversion occurs 7.3% of in-flight emergencies Deaths occurred 0.3% Smith Quick Facts regarding In-Flight Emergencies: 2.75

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Taming the SRU

FEBRUARY 22, 2023

EMS Grand Rounds with Dr. Connelly - R4 Case Follow up with Dr. Broadstock - R1 Clinical Knowledge: Vitamin Deficiencies WITH Dr. de Castro - Lecture R3 Small Groups Tox,Tasks,Rashes WITH Dr. Fabiano, Dr. Kein, and Dr. Martella4 - Palliative Medicine Consultation WITH Dr. Kiser EMS Grand Rounds WITH Dr. ConnelLy What I learned in my time with Sydney (..)

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 40

EMDocs

OCTOBER 5, 2024

We’ll keep it short, while you keep that EM brain sharp. ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants.

EMS 93

EMS Infectious Diseases Sepsis Hospitals 93

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 84

Seizures EKG/ECG Poisoning Shock 84

EMDocs

JULY 3, 2023

Authors: Mikalah Ward, MD (EM Resident Physician, University of Kentucky); Susan Owens, MD (EM Attending Physician, University of Kentucky) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Unfortunately, seizures in patients with SAH increase the risk of rebleeding.

Seizures 98

Seizures Stroke Outcomes EMS 98

ACEP Now

MARCH 11, 2025

16 An elevated amylase suggests repetitive vomiting as well. A special thanks to Dr. Samantha Martin and Dr. Jennifer Tomlin for their expertise in the EM Cases podcast that inspired this column. 16 Refeeding syndrome occurs when feeding is started after a period of prolonged deprivation.

Emergency Department 52

Emergency Department Psychiatric Dehydration Pediatrics 52

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.

Seizures 52

Seizures EKG/ECG CPR Shock 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. The rhabdo is believed to be due, in part, to associated seizures, muscle tremors, and agitation. Jeff: And the etiology of CHS is not well understood.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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. Farmers treating sheep for parasites may be symptomatic after exposure, an illness called Dipper’s Flu. 1 Avoid cholinergic agents that will exacerbate symptoms.

PPE 89

PPE Poisoning Seizures Emergency Department 89

Dr. Smith's ECG Blog

JANUARY 21, 2023

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?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

EMDocs

NOVEMBER 13, 2023

Authors: Mary Hamblen, DO (EM Resident Physician, TX); Justin Hacnik, MD (EM Resident Physician, TX); Katherine Spencer, MD (EM Resident Physician, TX); J.D. 29 The Memphis Criteria ( Table 2 ) have been proposed as an alternative to the Denver model in screening for possibility of BCVI and performs approximately as well.

Stroke 103

Stroke Radiology Radiology Emergency Department 103

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 105

Emergency Department Fractures Burns EMS 105