The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. We have covered fever before on the SGEM in pediatric patients.

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

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

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

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The Pediatric Assessment Triangle is a rapid, global assessment tool using only visual and auditory clues to make determinations on three key domains: appearance, work of breathing, and circulation to the skin. Pediatr Clin N Am. You have all of the skills you need to care for an acutely ill infant. 2006; 53:69-84.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

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. For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. What if this does not work?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Pediatric Emergency Playbook

MAY 1, 2017

Pediatrics. Pediatrics. He will be dehydrated – possibly in shock. Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. Pediatrics. Pediatrics. Pediatrics. Pediatrics. This will tell you: home or admission. Can I go Home Now? Bhutani et al.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2017

The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. J Curr Pediatr. World Journal for Pediatric Congenital Heart Surgery. Pediatr Cardiol. Pediatr Rev. 2017; 15:47-50. Hastings RS et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Taming the SRU

APRIL 13, 2023

EtOH, amphetamines, or cocaine) Prescription drugs (i.e. beta blockers decrease ability to dissipate heat through increase CO, diuretics predispose to dehydration, or anticholinergic agents can affect thermoregulation) Clinical Presentation: Temperature elevation, usually 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

PEMBlog

OCTOBER 2, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. Topics covered include: The pathophysiology of GER and GERD in the pediatric population. J Pediatr Gastroenterol Nutr. J Pediatr Gastroenterol Nutr.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 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? Intraosseous Infusion.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

HELLP Syndrome [pdf] Sara Paul MD Intrauterine Fetal Demise [ppt] Irene Hwang, MD Obesity in Pregnancy [pdf] Rafael Garabis, MD Seizures in Pregnancy [ppt] Sherifia Heron , MD Substance Abuse in Pregnancy [ppt] Sophia Y. Journal of Emergencies, Trauma and Shock, 3(1), 39. Episiotomy [ppt] Alice Teich, MD. Capriola, M.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

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 84

Seizures EKG/ECG Poisoning Shock 84

Critical Care Now

JUNE 21, 2022

His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Paramedics continued chest compressions, gave epinephrine via an intraosseous route, and delivered one shock. Later in the pediatric intensive care unit (PICU), he developed pulmonary edema, but he continued to improve neurologically.

Seizures 52

Seizures EKG/ECG CPR Shock 52

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: For more on synthetic intoxications in the ED, be sure to take a look at the recent May 2018 issue of Pediatric Emergency Medicine Practice on Synthetic Drug Intoxication in Children if you haven’t already read it.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Implantable Cardioverter-Defibrillator ), with long-term potential for device-related complications from the ICD, including inappropriate shocks? VF w as induced at EP study in 9 of 19 patients (47%). An SCN5A mutation was found in 14 of 28 patients (50%).

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Taming the SRU

SEPTEMBER 1, 2023

Can also extend this logic to those with TBI’s or trauma patients are inebriated Can attempt try to mitigate the risk and harm associated with iWBCT’s Future use of low-dose iWBCT Full-body MR imaging is already being used in pediatric patients Logistic regression in REACT-2 patient population identified 10 characteristics to warrant iWBCT in patients (..)

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

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.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Pediatric EM Morsels

MARCH 7, 2025

Let’s take a moment to review TXA (Tranexamic Acid) in Pediatrics! Wouldnt it be nice if there were adjuncts to prevent further bleeding or add benefit when blood may not be option (prehospital)? Enter TXA or tranexamic acid , The Clot Stabilizer!Let’s mg/kg [Nishijima 2016] Poorly studied in renally impaired patients.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

Don't Forget the Bubbles

FEBRUARY 24, 2025

Infants usually present in a non-specific manner, following an apnoea, cough, cyanosis, or seizure so a high index of suspicion is required in this age group. Pertussis: severe clinical presentation in pediatric intensive care and its relation to outcome. Pediatr Crit Care Med J. Pediatrics. Pediatrics. Pediatrics.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Taming the SRU

JUNE 6, 2023

HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5 million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Taming the SRU

NOVEMBER 13, 2024

opiates or anticholinergics): Use initial nomogram and treat if initial level is above the treatment line. haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S.,

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Don't Forget the Bubbles

JULY 5, 2023

Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. Do not use pethidine since it can cause seizures and CNS hyperexcitability. Pediatr Allergy, Immunol Pulmonol 2017; 30: 191–201. coli and Staphylococcus aureus. Anemia ; 2015.DOI:10.1155/2015/791498.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

OCTOBER 9, 2023

It shocked me how big an effect this expert had on the teams, especially given the studied teams usually worked together and had an average of seven years of neonatal experience. A 13-year-old girl came to the ED with an unprecedented, prolonged seizure. When she arrived in the department, the seizure had stopped. K, Leiter M.

Seizures 116

Seizures Incident Reporting Emergency Department Research 116

EMDocs

MARCH 11, 2024

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. 18 Patients with signs and symptoms of severe dehydration or shock, including stupor, coma, uncontrollable vomiting, extreme fatigue that prevents drinking, and unstable vital signs should receive IV fluid resuscitation.

Dehydration 107

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 107

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 72

Infectious Diseases CDC PPE Rapid Diagnostic Testing 72