I first heard about this article on Scott Weingart’s RACC Lit review, where he discussed it as a practice changing paper. In that context, I was excited to read it. I downloaded it as soon as I got out of the car. I will admit, I was pretty biased at […]
seizure
7 posts
Time for another semi-regular round-up of the top emergency medicine and critical care articles I have encountered over the last few months. This time we will tackle anti-epileptics, anti-emetics, the word “quiet”, and a whole bunch more…
My approach to status epilepticus is somewhat more aggressive than commonly taught algorithms. It is summarized (overly simply) as “benzo → benzo → propofol”. There have been a number of concerns raised with this strategy recently on twitter. This post outlines the reasoning (and limited evidence) behind my seizure algorithm.
Case EMS arrives with a 39 year old woman in the midst of a generalized tonic clonic seizure. The seizure has lasted at least 12 minutes now, so this is status epilepticus. No information is available about her past history. The paramedics were unable to start an IV, but did […]
Status epilepticus is associated with a high degree of morbidity and mortality. Approximately ⅓ of patients have long term neurologic sequela, and mortality is 3-5%. (Chin 2006; Raspall-Chaure 2006) First line treatment is with benzodiazepines, but benzos will fail approximately 30-40% of the time. (Appleton 2008) Therefore, an effective second […]
A brief review of key actions during the first 10 minutes in the resuscitation room with a patient in status epilepticus