Dr. Smith's ECG Blog

JANUARY 21, 2023

The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. EMS reported an initial GCS of 8 with pupils equal and reactive.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

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 GCS must be obtained through interaction with the patient (i.e., The GCS must be obtained through interaction with the patient (i.e.,

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Don't Forget the Bubbles

AUGUST 12, 2024

After a traumatic brain injury, all children and young people should have a C-ABCDE rapid assessment for life-threatening injuries (as per ATLS guidelines) focussed on trauma resuscitation and stabilisation, followed by a secondary assessment. Do we need seizure prophylaxis?

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Broome Docs

OCTOBER 31, 2022

Safety and efficacy of prophylactic levetiracetam for prevention of epileptic seizures in the acute phase of intracerebral haemorrhage (PEACH): a randomised, double-blind, placebo-controlled, phase 3 trial. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Lancet Neurol. 2022 Sep;21(9):781-791. 2018 Sep 11;362:k3843.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypothermia, hypotension, and vasoconstriction may affect pulse oximetry reading, which is based on light absorption from fingertip blood flow. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Decreases splinting and improves tidal volumes.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

Mind The Bleep

OCTOBER 17, 2024

Clinically, your enthusiasm for providing maximal quality care needs balanced against rescue practicalities and a hostile environment (very different to your warm, dry resuscitation bay) – the cold makes all veins disappear…and you may be the only clinician responder at the scene. Each year a team usually reports CPR being delivered.

Soft Tissue Injuries 52

Soft Tissue Injuries Seizures Ambulance Services Teamwork 52

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Exposure Expose the patient in a systematic manner while keeping remaining body areas covered e.g. 1 limb at a time, to reduce the risk of hypothermia. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

DECEMBER 16, 2023

As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. A 12-lead EKG shows sinus tachycardia but is otherwise normal. What is your diagnosis, and what are your next steps in evaluation and management? 1 Fever is usually < 40C. 1 Fever is usually < 40C. Temps greater than 41.5C Temps greater than 41.5C

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5

Documentation/Coding 63

Documentation/Coding Seizures Psychiatric Wellness 63

PulmCCM

JANUARY 20, 2025

New guidelines on cardiopulmonary resuscitation in adults were published in Circulation in November 2024. The International Liaison Committee on Resuscitation (ILCOR) is comprised of experts on resuscitation around the world. Seizure Prophylaxis and Treatment of Abnormal EEGs Read more They’re 187 pages long.

CPR 65

CPR Resuscitation Hyperthermia / Hypothermia Seizures 65

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

Infectious Diseases 57

Infectious Diseases CDC PPE Rapid Diagnostic Testing 57