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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

Treat the seizures , but…. Keep in mind that seizure management can be difficult and the patient may not respond to AEDs. These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. May see non-specific white and gray matter changes. 2020 Feb;75:55-62.

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. This resource offers additional information on ultrasound assisted LP’s. As may be seen in the table below, there are several themes as well a range of stringency.

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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

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.

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

She reportedly received a landmark guided peripheral nerve block with bupivacaine and shortly thereafter developed generalized seizures. 1,5] CNS symptoms include: Seizure, coma, altered mental status. [1] 3] If performing a nerve block with ultrasound guidance, always know where the tip of your needle is. [5] mL/kg/min. [2]

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Grand Rounds Recap 5.22.24

Taming the SRU

Get a blood gas when possible to help guide your ventilation. glenn, haffner, and jackson In Flight Emergencies: As a responding physician to an in-flight emergency, you may recommend diverting the plane, however, the captain (lead pilot) will make the final decision.

Shock 91
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What Are the Classifications of Perinatal Stroke?

Pediatric Education

The past medical history showed she was a 38 week infant who had neonatal seizures that were easily controlled. She was weaned off antiepileptics after not having additional seizures several months later. Other imaging (often ultrasound) may be used depending on patient clinical status, imaging availability and timing.

Stroke 52
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Grand Rounds Recap 3.8.23

Taming the SRU

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