EMDocs

JANUARY 8, 2024

Magnesium does not improve ROSC, survival, or neurologic outcomes, no matter the presenting rhythm (Level 3: no benefit). Avoid routine seizure prophylaxis in adult survivors of cardiac arrest (Level 3: no benefit), but treat seizures if they occur (Level 1: strong). o C recommended (Level 1: strong). COR 1, LOE C-LD.

Seizures 98

Seizures Shock CPR Hyperthermia / Hypothermia 98

EMDocs

JANUARY 11, 2024

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. EEG Monitoring and Seizures Statements Takeaway: If possible, obtain an EEG to evaluate for seizure activity.

Seizures 98

Seizures Shock Infectious Diseases CPR 98

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 94

Sepsis Shock Resuscitation Fluid Resuscitation 94

Don't Forget the Bubbles

OCTOBER 23, 2023

They may also already have other seizure types and be under paediatric services. Maintenance therapy is sometimes required in patients with higher seizure risks. Outcomes are extremely variable, dependent on the cause, and include developmental delays, neurodivergence, or behavioural issues. How are Infantile Spasms diagnosed?

Seizures 75

Seizures Outcomes Wellness 75

Dr. Smith's ECG Blog

MAY 8, 2014

In 49 patients with known TCA overdose , a maximum limb lead QRS duration greater than 100 ms was 100% sensitive for detecting patients who will seize, and seizure is a harbinger of cardiovascular collapse. 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

Taming the SRU

OCTOBER 5, 2023

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 91

Stroke EKG/ECG Seizures CPR 91

Dr. Smith's ECG Blog

MARCH 30, 2014

They were worried that the syncope was seizure and that she had brain mets. Outcome and Analysis: ECG 1 is diagnostic of inferior and right ventricular MI. Previous ECG. The lactate was elevated and pH low. Then they were worried about sepsis as an etiology of hypotension. Troponin was repeated and returned higher still.

EKG/ECG 52

EKG/ECG Outcomes Shock Sepsis 52

Mind The Bleep

OCTOBER 29, 2024

These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Taming the SRU

JUNE 3, 2024

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both. Benefits of transport are evidenced based.

Shock 91

Shock Seizures Airway Management Stroke 91

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes.

Stroke 101

Stroke Outcomes EMS Seizures 101

The Skeptics' Guide to EM

DECEMBER 16, 2017

Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure. It was a witnessed clonic-tonic seizure that stopped but he did not wake up. The paramedics report another seizure on route to the hospital. He then has another seizure in the department. Reference: Legriel et al.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

Taming the SRU

JUNE 26, 2023

morbidity and mortality - wellness: behind the curtain Morbidity and mortality WITH dr. zalesky Meningitis Meningitis is an extremely difficult diagnosis with almost no clinical findings that can aid in the diagnosis outside of suspicion and a LP Seizures can be a presenting sign of infections, often without fevers or leukocytosis Of patients with (..)

Seizures 52

Seizures Best Practices Wellness Outcomes 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Definition of status epilepticus:Continuous seizure activity of 5 minutes or greater – OR – Recurrent activity without recovery between intervals. This definition includes clinically apparent seizures as well as those seen only on EEG.) During a seizure, GABA receptors in the neuron’s membrane are internalized and destroyed.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

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

Dr. Smith's ECG Blog

JUNE 17, 2016

He had a seizure this morning and rolled out of bed unable to get up. What was the outcome? Outcome "I later found out that this is a patient who regularly calls paramedics to c/o chest pains and he had fooled many of them. The patient is a 36yo man who was seen for a seizure. This also argues against STEMI.

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Both of these also cause seizures. Here is the history : Male in 40's who had seizures and was unconscious. There was a good outcome. Common culprits in this situation are tricyclic overdose and cocaine toxicity (remember cocaine not only increases dopamine in central synapses, but is also a local anesthetic (-caine!)

Seizures 52

Seizures Administration Outcomes Hospitals 52

Dr. Smith's ECG Blog

FEBRUARY 4, 2023

He had a seizure this morning and rolled out of bed unable to get up. What was the outcome? Outcome "I later found out that this is a patient who regularly calls paramedics to c/o chest pains and he had fooled many of them. The patient is a 36yo man who was seen for a seizure. This was posted a few years ago.

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neuroscience and Biobehavioral Reviews. 2005; 29: 493–500.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

He is not on anticoagulation and there is no history of seizures. In an attempt to improve resource utilization, emergency department length of stay, limit cost and improve outcomes, there have been multiple Clinical Decision Rules (CDRs) created to help guide clinicians in their decision-making process.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

Dr. Smith's ECG Blog

NOVEMBER 18, 2019

Case outcome The Na was 109. This was the etiology of seizures. Of course this is not a difficult case because one will always measure the K in such a case, but it does show that the K is markedly affecting cardiac electrical activity. He was treated with hypertonic saline. Volume was down, and so repleted.

EKG/ECG 52

EKG/ECG Seizures Stroke Wellness 52

Emergency Medicine Cases

MAY 28, 2024

Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What is the evidence for oral nimodipine in improving outcomes in patients with subarachnoid hemorrhage and how does it work? Mortality in SAH patients can be up to 30% even without neurological deficit.

EMS 52

EMS Outcomes Seizures Resuscitation 52

Taming the SRU

APRIL 13, 2023

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. EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 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. Long-term outcome is unknown. He was quickly rushed to the CT scanner and a noncontrast head CT was completely normal. Serial troponins were negative.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2016

We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. We should use lactate to detect occult shock. Clinical Chemistry.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

These indices would have reinforced the clinical decision progress and avoided bad outcomes from unsuccessful estimates. So much more than just a BP cuff and a rhythm monitor. Disposable BVMs (one at every bedside). Yes, there's a crash cart —at the end of the ward's hallway from me.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

EMDocs

DECEMBER 18, 2024

Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 106

Seizures Hyperthermia / Hypothermia Emergency Department EMS 106

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. The aim of TTM is to control the body and brain’s temperature, thus reducing secondary brain injury and improving the neurological outcome.

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient was in his 50s with history of hypertension, diabetes, seizure disorder, and smoking, but no known coronary artery disease. Angiographic and clinical outcomes among patients with acute coronary syndromes presenting with isolated anterior ST-segment depressions. The recommended value for V2 and V3 is now 1.5 Pride et al.

EKG/ECG 40

EKG/ECG Seizures Documentation/Coding Outcomes 40

Don't Forget the Bubbles

JANUARY 24, 2024

Four-year-old Fern is a previously healthy girl who presents with a febrile illness and seizures. Seizure activity did not respond to either first or second-line treatments, so she needed rapid sequence induction and transfer to PICU for ongoing anaesthesia and management. What causes Super Refractory Status Epilepticus?

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

EMDocs

DECEMBER 6, 2024

Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. 7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Can progress to hepatic failure.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

EMDocs

MAY 25, 2023

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 mg/kg or 10 mg Intravenous lorazepam 0.1

Seizures 91

Seizures Administration Anaphylaxis Outcomes 91

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 105

Seizures Dehydration Documentation/Coding Infectious Diseases 105

RebelEM

FEBRUARY 15, 2024

not a patient oriented outcome) Single country study which may limit generalizability Excluded pregnancy where risk of emesis is increased due to gravid uterus Alcohol was the implicated in the overwhelming majority of patients.

Poisoning 141

Poisoning Airway Management Seizures Shock 141

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

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 93

Seizures EKG/ECG Poisoning Shock 93

PulmCCM

JANUARY 29, 2024

EEG Advised, to Rule Out Nonconvulsive Seizures Nonconvulsive seizures are occasionally present in comatose patients after cardiac arrest, undetectable without testing. Seizure prophylaxis was advised against, as there is no evidence for its efficacy.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Don't Forget the Bubbles

NOVEMBER 29, 2024

Neurological Effects : Headache, dizziness, seizures, or coma due to cerebral oedema. Predictors of Mortality The prognosis of methanol poisoning depends on several factors, with certain clinical and biochemical markers strongly associated with poorer outcomes. Permanent blindness is a significant risk without treatment.

Poisoning 64

Poisoning Forensics Seizures Outcomes 64