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. On arrival, he is obtunded, foaming at the mouth, and exhibiting generalized tonic-clonic seizure activity. Clinical Question » How should status epilepticus be diagnosed?

Seizures 52

Seizures Emergency Department Outcomes EMS 52

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. Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications.

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Pediatrics Infectious Diseases Seizures Hospitals 130

Don't Forget the Bubbles

JUNE 30, 2023

And hot off the press… the international PATCH ( P rehospital A ntifibrinolytics to T rauma C oagulopathy and H aemorrhage) study (just published on 14th June 2023) compared a prehospital TXA bolus, followed by an eight-hour infusion with placebo in more than 1300 adult patients from 21 hospitals across three countries. in the placebo group).

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

PEMBlog

SEPTEMBER 13, 2023

Team members and families eagerly await your intervention to halt the seizure and understand its underlying cause. The lack of utility of laboratory testing in children with an unprovoked generalized seizure, or a simple febrile seizure is supported by several observational studies.

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Seizures Pediatrics Point-of-Care Testing Wellness 52

EMDocs

JUNE 9, 2023

How do we manage the agitated child in the pre-hospital environment? 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. mg/kg IN; 0.1-0.15

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EMS Documentation/Coding Pediatrics Psychiatric 95

EMDocs

JANUARY 17, 2024

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) 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9) Benzodiazepines are first-line therapy for seizures.

Poisoning 81

Poisoning Seizures Pediatrics EMS 81

Don't Forget the Bubbles

AUGUST 12, 2024

Do we need seizure prophylaxis? Children and young people have lower seizure thresholds than adults. Following TBI, seizures are common and may be missed in children and young people who are sedated and paralysed. Either levetiracetam or phenytoin can be used for seizure prophylaxis. Pediatr Crit Care Med.

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Seizures Pediatrics Emergency Department Ambulance Services 75

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. There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day.

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Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. We have covered fever before on the SGEM in pediatric patients. Critical Care Medicine 2017.

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Sepsis Emergency Department Seizures Pediatrics 52

The Skeptics' Guide to EM

DECEMBER 7, 2019

Pediatrics 2019 Guest Skeptic: Dr. Katie Noorbakhsh is a pediatric emergency physician at the Children’s Hospital of Pittsburgh. This is an SGEM Xtra and it was inspired by the recent publication in Pediatrics on BRUEs. […] The post SGEM Xtra: Strange BRUE first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms. TXA in head injuries.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

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 71

Poisoning Seizures Fluid Resuscitation Pediatrics 71

Pediatric Emergency Playbook

OCTOBER 1, 2017

J Neurosurg Pediatrics. Vagus nerve stimulation for partial seizures. Complications of Intrathecal Baclofen Pump Therapy in Pediatric Patients. J Pediatr Orthop. Pediatr Neurosurg. for the Pediatric Heart Transplant Study Investigators. Prospective Trial of a Pediatric Ventricular Assist Device.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). A similar process can also occur in the CNS (causing seizures ), the liver and the pancreas. It is also worth noting that immunocompromised children are more likely to have a sinister cause. What is atypical HUS?

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

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

EMDocs

MAY 15, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. 25% have an infection as the trigger for ACS.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2 mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2 mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

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

EMDocs

MAY 28, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. 25% have an infection as the trigger for ACS.

Blood Transfusions 94

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 94

PEMBlog

SEPTEMBER 6, 2023

However, the vast majority of pediatric patients with psychiatric complaints do not present with undifferentiated acute psychosis; rather, they are seen for behavioral concerns or suicidal ideation. Decades ago, psychiatric complaints in the pediatric ED were infrequent.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

Taming the SRU

FEBRUARY 5, 2024

For pediatric patients, we recommend using the PECARN Pediatric Head Injury Algorithm. These patients are often admitted to the hospital. Admission should also be strongly considered in patients with a depressed GCS, post-traumatic seizure(s), or intractable symptoms [2]. JAMA Pediatr. JAMA Netw Open.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Taming the SRU

MARCH 14, 2023

After a several week NICU stay for prematurity, the infant has been generally healthy and this is his first trip back to the hospital since discharge. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. His abdomen is soft.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

MAY 1, 2023

Trauma/Pre-Hosp Optimal Out-of-Hospital Blood Pressure in Major Traumatic Brain Injury: A Challenge to the Current Understanding of Hypotension Link: [link] Bottom Line: Think about maintaining normotension rather than simply avoiding hypotension in isolated TBI. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Don't Forget the Bubbles

JULY 26, 2023

Some families have unexplained deaths during sporting events, an unusual number of car accidents, seizures in someone without a formal diagnosis of epilepsy. This has been trialled (out of hospital) in known children with SVT. On arrival at hospital the child was well with normal observations. www.cats.nhs.uk/wp-content/uploads/guideline-intubation.pdf

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EKG/ECG Hospitals Shock Documentation/Coding 98

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? This is especially true in children – the majority of pediatric ambulatory visits do not require blood work to make a decision about acute care. The punchline is, use a pediatric reference.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

MAY 1, 2017

Pediatrics. Pediatrics. Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. Hospital Stay for Healthy Term Newborn Infants. Pediatrics. Pediatrics. Pediatrics. Pediatrics. Pediatrics. Pediatrics in Review. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 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

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

These include, but are not limited to the following: · Persons dying within 24 hours of admission to the hospital, or not medically attended by a physician within 24-hours of the time of death, unless the attending physician has established a natural cause of death. ·

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

ACEP Now

MAY 10, 2024

A 9-month-old male presents to emergency department (ED) with his mother for seizure. The child was diagnosed with seizure disorder at 2 months of age and has had multiple visits to the emergency department (ED) for seizures. The child was started on Levetiracetam and levels always have been normal despite breakthrough seizures.

Forensics 98

Forensics Psychiatric Seizures Pediatrics 98

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 blind weight should be obtained post-void with the patient in a hospital gown only (to prevent hidden weights), and the patients back to the weight display.

Emergency Department 52

Emergency Department Psychiatric Dehydration Pediatrics 52

Don't Forget the Bubbles

MAY 15, 2023

As such, thresholds for intervention remain under debate and vary across different hospitals and countries. Signs and symptoms in this group are often non-specific and can include irritability, hypotonia, lethargy, jitteriness, temperature instability, poor feeding, vomiting, apnoea and seizures. The Journal of Pediatrics.

Wellness 103

Wellness Seizures Hospitals Dehydration 103

PEMBlog

JULY 10, 2024

” Emily Labudde, MD, a Pediatric Emergency Medicine fellow at Children’s Healthcare of Atlanta and recent pediatric residency graduate from Cincinnati Children’s discusses the various manifestations of this sexually transmitted infection, and how we can’t miss this very treatable, but sneaky malady. .”

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. En route to the hospital, the patient began to move all of his extremities and responded to painful stimuli. Hospital Course: The patient was intubated upon arrival in the ED and sedated with propofol.

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. 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

Don't Forget the Bubbles

AUGUST 13, 2023

Most febrile seizures are generalized tonic clonic seizures, lasting for a few minutes (less than 10 mins) and are conventionally classified as being simple (70%) and complex (30%). Simple febrile seizures are generalized (i.e. Any febrile seizure lasting for > 30 mins is considered febrile status epilepticus.

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Seizures Pediatrics Dehydration Radiology 97

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.

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Poisoning Airway Management Seizures PPE 97

Taming the SRU

SEPTEMBER 1, 2023

Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival.

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Sepsis Fractures Documentation/Coding Administration 95