EMDocs

SEPTEMBER 24, 2024

Episode 107: Eclampsia Definition: Severe hypertensive disease of pregnancy (HDP) with new onset tonic-clonic, focal, or multifocal seizures or unexplained altered mental status in a patient who is pregnant or postpartum and there’s no other causative etiologies. Approximately one third have no findings of preeclampsia before the seizure.

Seizures 95

Seizures Stroke EKG/ECG 95

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.

EKG/ECG 128

EKG/ECG Seizures Stroke EMS 128

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. On ED arrival GCS is 3, there are rapid eye movements to the right but no other apparent seizure activity. Check glucose, obtain imaging, stop the seizure. They administer two doses of 10 mg midazolam IM.

Seizures 83

Seizures Documentation/Coding EKG/ECG Emergency Department 83

Emergency Medicine Ireland

APRIL 29, 2024

Hopefully what follows will provide enough broad brush strokes to get you through a night on call or even worse a viva. They have a seizure on arrival and a Na comes back at 105. In this scenario they are seizing because of the low Na and rapid increase of the Na is needed to stop the seizure.

Seizures 75

Seizures Sepsis Stroke Administration 75

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 90

Stroke EKG/ECG Seizures CPR 90

Dr. Smith's ECG Blog

OCTOBER 25, 2023

A New Seizure in a Healthy 20-something More cases of long QT not measured correctly by computer (these are all fascinating ECGs/cases): Bupropion Overdose Followed by Cardiac Arrest and, Later, ST Elevation. Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest.

EKG/ECG 127

EKG/ECG Seizures Hospitals Stroke 127

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

Taming the SRU

FEBRUARY 5, 2024

As may be seen in the table below, there are several themes as well a range of stringency. Find the posterior superior iliac crest and draw an imaginary line across the back (Tuffier’s line) – where this line crosses midline is the L4 spinous process.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

Ziqitza HealthCare Ltd

JUNE 13, 2024

Difficulty speaking Sudden speech difficulties, weakness, or numbness could be an emergency medical warning sign of a stroke. Major issues like stroke, internal bleeding, low blood sugar levels, and sudden drops in blood pressure could all accompany this warning sign. These also require emergency medical intervention at the earliest.

Burns 52

Burns Stroke Ambulance Services Seizures 52

Taming the SRU

JUNE 3, 2024

Susan Wilcox Increasing regionalization due to: Growth of specialty centers Increasing development of healthcare systems Hub-and-spoke models Development of ECMO, trauma, transplant, and stroke centers The higher the acuity of the centers, the higher the acuity of the patient that needs to get there.

Shock 91

Shock Seizures Airway Management Stroke 91

Taming the SRU

JANUARY 26, 2024

Morbidity & MOrtality - Mini Lit Blitz - Post-Rosc Care - Qi/KT Morbidity & Mortality WITH Dr. Yates Case 1: Stroke and Stroke Mimics Early diagnosis of stroke improves stroke outcomes, where misdiagnosis is associated with an upwards of 4-time higher likelihood of mortality Missed strokes most often occur with atypical symptoms, in younger (..)

Stroke 59

Stroke EKG/ECG Seizures Outcomes 59

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

ACEP Now

AUGUST 12, 2024

The differential included ischemic stroke, focal seizure disorder, lesion of the cervical spine, sequalae of prior Bell’s palsy, hemorrhage, or psychological disorder. CT of the brain was unremarkable, suggesting against any acute pathologies such as ischemic stroke, large hemorrhage, or tumor burden. Diabetes Care.

Stroke 52

Stroke Leadership Seizures 52

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

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. The case was reviewed by the receiving team who had concerns for acute stroke or other cause of acute altered mental status. Serial troponins were negative.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

Pediatric Education

FEBRUARY 18, 2024

There was no reported respiratory distress or problems handling secretions and no obvious seizure activity. Seizures, cerebrovascular problems and central nervous system tumor swirl in professionals’ heads as they take in the history, physical examination and start to evaluate and manage the problem. How are seizures classified?

Seizures 40

Seizures Pediatrics Psychiatric Radiology 40

EMDocs

MAY 15, 2024

Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia.

Blood Transfusions 90

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 90

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. Vagus nerve stimulation for partial seizures. Are VNS safe in everyday life? Intrathecal Pumps Used to infuse basal rate of drug, usually baclofen for spasticity, but pump may contain morphine, bupivicaine, clonidine. Verify the medication and identify the toxidrome if symptomatic.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

EMDocs

MAY 28, 2024

Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS). Underestimates alveolar hypoxemia.

Blood Transfusions 88

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 88

Sensible Medicine

JUNE 30, 2023

By the time she died, this management had included intravenous fluids, pain medications, antiemetics, and seizure medications. There was fatigue, weight loss, nausea, declining kidney function, and a few strokes. I managed her evaluation and her care while she remained an outpatient. She was in her late 70’s and she was dying.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

Downeast Emergency Medicine

APRIL 26, 2021

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] MI or stroke).

Head Injuries 52

Head Injuries Administration Outcomes Seizures 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.,

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Pediatric Education

APRIL 28, 2024

Historically it was made after age 12 months, but can be made before 6 months.

Seizures 40

Seizures Pediatrics Dislocations Stroke 40

Dr. Smith's ECG Blog

MARCH 19, 2019

Think of : i ) Drugs ( many drugs prolong the QT interval — and combinations of drugs may result in marked prolongation ) ; ii ) “ Lytes ” ( ie, Think of low K+ — low Mg++ — and / or — low Ca++ ) ; and , iii ) a CNS Catastrophe ( ie, stroke, bleed, coma, seizure, trauma, brain tumor ).

EKG/ECG 52

EKG/ECG Seizures Stroke Operations 52

Taming the SRU

MAY 1, 2023

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

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. However, cardiac syncope is always a differential diagnosis when someone presents with first time seizures. There are a number of things to look for in an ECG that can hint at arrhythmia as the cause of an apparent seizure.

Seizures 115

Seizures EKG/ECG EMS Stroke 115

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

PEMBlog

SEPTEMBER 6, 2023

Life threatening non-psychiatric causes of acute psychosis include hypoglycemia, cerebral hypoxia, drug toxicity, CNS abnormalities (such as brain tumor, meningoencephalitis, injury, seizures, or stroke), metabolic conditions, electrolyte disturbances, hepatic failure, uremia, or thyrotoxicosis.

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

Pediatric Education

MARCH 3, 2024

Eclampsia is a severe complication of pre-eclampsia that has new onset seizures. Long term, infants have higher risks of hypertension, stroke and increased body mass index. .” Estimate are between 1 – 5.6% of pregnancies have pre-eclampsia. Pre-eclampsia classification is based on symptoms.

Pediatrics 40

Pediatrics Seizures Wellness Stroke 40

Don't Forget the Bubbles

FEBRUARY 5, 2025

Other considerations in significant TBI would be the temporary use of anti-epileptic drugs as prophylaxis to prevent early post-traumatic seizures to aid neuroprotection; the most commonly used would be levetiracetam. Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Dr. Smith's ECG Blog

AUGUST 13, 2020

He had a h/o ischemic cardiomyopathy and right MCA stroke. The patient was awake at this point, lactate was 7 mEq/L and so seizure was suspected as the etiology of the transient loss of consciousness and gaze deviation. The patient initially presented with a report of SOB prehospital, but this he denied.

EKG/ECG 52

EKG/ECG Shock Stroke Seizures 52

ACEP Now

APRIL 2, 2024

8 Seizures and thunderclap headache from reversible cerebral vasoconstriction syndrome have been reported. 8,9 There is one case of a 17-year-old who died from acute cerebellar stroke after participating in the “One Chip Challenge” (eating a capsaicin infused food chip as a game) that prompted Hershey Co. to recall the product.

Burns 40

Burns Poisoning Seizures Stroke 40

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. S – seizure or shock – most commonly septic, but can be any type: cardiogenic, bstructive, hypovolemic, distributive. Don't go looking, if you won't do anything with the test.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

JUNE 1, 2017

The previously well child now decompensated: undiagnosed thrombophilia Asymptomatic patent foramen ovale (PFO) is the cause of some cases of cryptogenic vascular disease, such as stroke and MI. Viral myocarditis Presenting with Seizure and Electrocardiographic Findings of Acute Myocardial Infarction in a 14-Month-Old Child.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. Do not use pethidine since it can cause seizures and CNS hyperexcitability. What is the role of transcranial dopplers in primary prevention of strokes?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126