Taming the SRU

JUNE 3, 2024

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

Shock Seizures Airway Management Stroke 91

EMDocs

MAY 28, 2024

Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% While chest radiograph is often the first-line imaging modality, lung ultrasound has higher sensitivity and can detect pulmonary abnormalities earlier; CT imaging should be considered if initial imaging is negative or if concern for PE is present. pneumoniae, C.

Blood Transfusions 94

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 94

Pediatric Education

APRIL 30, 2023

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

Stroke Seizures Pediatrics Hyperthermia / Hypothermia 52

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

Taming the SRU

FEBRUARY 23, 2024

Clinical pathologic case presentation - r1 diagnostics/therapeutics: Lumbar punctures - AIRWAY GROUND ROUNDS- r4 capstone - r3 taming the sru - ultrasound grand rounds Clinical pathologic case presentation WITH Drs. If assessing for SAH, xanthochromia may not appear until 12 hours after onset, though may appear after 2-4 hours.

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

SheMD

JULY 6, 2023

Picture this: you discover your neurology preceptor is studying seizure disorders in children, and you happen to be interested in pediatrics. During my OB rotation, I also spent a couple of days with the ultrasound technicians so I could work on my ultrasound skills and learn how to read ultrasounds.

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Ultrasounds Research Seizures Pediatrics 52

Dr. Smith's ECG Blog

OCTOBER 22, 2017

This was sent by a recent ultrasound fellow, asking for my ECG diagnosis. This patient presented with altered mental status and seizure, so the diagnosis of Takotsubo can be made without angiography or even echo. He stated that it is "an acute change from previous" in an elderly smoker with hypertension, syncope, and abdominal pain.

Seizures 52

Seizures EKG/ECG Ultrasounds 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Vagus nerve stimulation for partial seizures. Ultrasound-guided refilling of an intrathecal baclofen pump—a case report. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neuroscience and Biobehavioral Reviews. 2005; 29: 493–500. Panebianco M, Rigby A,Weston J,Marson AG.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

He is interested in ultrasound and international emergency medicine. He is not on anticoagulation and there is no history of seizures. She is interested in social determinants of health in the emergency department and health policy. He is neurologically intact with a Glasgow Coma Scale (GCS) of 15 one hour after the fall.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Was there any prenatal care or ultrasound done? Perhaps diGeorge syndrome with hypocalcemia and seizures? Inborn Errors of Metabolism - there are over 200 inborn errors of metabolism, but only four common metabolic pathways that cause a child to be critically ill. Look for clitoromegaly in girls, or hyperpigmented scrotum in boys.

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Seizures Sepsis Pediatrics Shock 40

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

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Keep your ultrasound handy. 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. Here, then, are some links for Third Trimester Emergencies.

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OB/GYN Ultrasounds Emergency Department Resuscitation 40

Taming the SRU

MAY 30, 2023

hours earlier and went to OR 3.5 hours earlier and went to OR 3.5

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

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] Lastly, the use of TXA is not without risk.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. The downside is that it can last 30 minutes or more, but it may be a good choice for an abdominal ultrasound or CT head in unruly toddlers.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

While Point of Care Ultrasound has made limited entry in prehospital care, largely with physician-led services and some Advanced Paramedics; it has largely been as a proof of concept rather than everyday care. I am thankful for having a career of wonderful care at supportive institutions. What I wish that I had then, that we have now … POCUS.

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Emergency Nursing Seizures CPR Wellness 40

Dr. Smith's ECG Blog

JANUARY 15, 2024

A bedside ultrasound should be done to assess volume and other etiologies of tachycardia, but if no cause of type 2 MI is found, the cath lab should be activated NOW. Smith comment: this is diagnostic of OMI until proven otherwise. Do not wait for the troponin; a lot of myocardium will be dead if you do.

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EKG/ECG Point-of-Care Testing Wellness Shock 65

PEMBlog

OCTOBER 2, 2024

This is sometimes misidentified as seizures. Now, ultrasound is useful if you suspect gallbladder disease, but the patient needs to be NPO for six to eight hours before the procedure. This will that the gallbladder is distended, which improves the accuracy of the ultrasound in visualizing gallstones or sludge or other abnormalities.

Pediatrics 52

Pediatrics Emergency Department Ultrasounds Wellness 52

Pediatric Emergency Playbook

JUNE 1, 2017

The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI. Cardiovasculr Ultrasound. Although methylphenidate is typically well tolerated, risks include dysrhythmias such as ventricular tachycardia.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Mind The Bleep

DECEMBER 31, 2023

encephalopathy, pericarditis, seizures) *common dialysable toxins include lithium, aspirin, theophylline along with many others. Depending on other aspects of the clinical scenario, a patient may well need dialysis out of hours but not have one of these indications.

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Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. His coach and fellow players witnessed a seizure-like activity immediately after collapsing. Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director.

Seizures 52

Seizures EKG/ECG CPR Shock 52

Don't Forget the Bubbles

OCTOBER 17, 2023

Baby boys have erections seen in utero during pregnancy ultrasound scans, and these continue after birth as a largely involuntary function. These are not true seizures but are commonly misdiagnosed as epilepsy or dystonia. If there is any concern about seizure activity, referral and investigation are, of course, warranted.

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Seizures Ultrasounds 80

EB Medicine

AUGUST 1, 2018

It was peer-reviewed by Joseph Habboushe, assistant professor at NYU and Nadia Maria Shaukat, director of the emergency and critical care ultrasound at Coney Island Hospital in Brooklyn, New York. The rhabdo is believed to be due, in part, to associated seizures, muscle tremors, and agitation.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

PEMBlog

JULY 10, 2024

At any stage, patients can develop neurosyphilis, that can present with vision changes, neuropathies, seizures, or altered mental status. Think about congenital syphilis in your little ones presenting like biliary atresia, who have a normal gallbladder treon ultrasound.

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

EB Medicine

FEBRUARY 1, 2019

Anyway, the last test to discuss is our good friend the ultrasound, specifically the ocular ultrasound. Seizures are very common as well. Ocular ultrasound can expedite the diagnosis and management of ocular emergencies and rapidly diagnose ICP by measuring optic sheath diameter. That’s quite a list.

Emergency Department 40

Emergency Department Stroke Ultrasounds Outcomes 40

Dr. Smith's ECG Blog

DECEMBER 5, 2019

A bedside cardiac ultrasound revealed grossly normal to hyperdynamic systolic function with no obvious areas of wall motion abnormalities. This was recorded about 30 minutes later: Same A previous ECG was obtained and was normal. The patient denied any chest pain whatsoever, and a troponin at zero and 2 hours were both undetectable.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Dr. Smith's ECG Blog

APRIL 8, 2015

First: Are you sure it was syncope, and not SEIZURE? Conversely , frequently syncope has a short episode of tonic-clonic activity that mimics seizure. Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

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

EMDocs

NOVEMBER 4, 2024

Headache red-flag characteristics include neurological symptoms, thunderclap nature, syncope, trauma, immunocompromised, coagulopathy, fever, rash, seizure, nuchal rigidity, altered mental status, pregnancy, temporal tenderness, jaw claudication, and cancer history. Evaluation by ultrasound of traumatic rib fractures missed by radiography.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

EMDocs

NOVEMBER 13, 2023

Semin Ultrasound CT MR 2017, 38 (4), 345-356. CTA head/neck is absolutely indicated if suspicion is high for this condition. 34 Risk factors are the same as those for other vascular causes of headache: connective tissue diseases, such as systemic lupus erythematosus, Behcet’s disease, sarcoidosis, and/or vasculitis. DOI: 10.1161/strokeaha.118.023173

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Stroke Radiology Radiology Emergency Department 103

Don't Forget the Bubbles

JULY 5, 2023

Do not use pethidine since it can cause seizures and CNS hyperexcitability. The high blood flow velocities through these stenotic segments can be detected using transcranial doppler ultrasound (TCD). Alternatives to morphine are hydromorphone or fentanyl. Annual screening with TCD is recommended to all SCD patients > 2 years old.

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Blood Transfusions Stroke Dehydration Sepsis 126

Pediatric Education

NOVEMBER 10, 2024

Consequently in addition to the routine testing that occurs with this type of delivery, it was decided to also include TORCH titers, an eye examination and head ultrasound for a potential congenital infection especially toxoplasmosis; all of which were normal. He had slow feeding during his stay and eventually left the NICU at day 7.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Resuscitation 40

EMDocs

FEBRUARY 3, 2025

These complications affect both the central and peripheral nervous systems and encompass a wide range of conditions, including transient ischemic attacks (TIA), stroke, headaches, mood disorders, seizures, psychosis, neuropathy, and cognitive dysfunction (1,6,7).

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Stroke EMS Seizures Outcomes 64