I took a few months off. (Well, not so much off, but as stuck in other EBM rabbit holes.) I am sure some were happy for the empty inbox, but if you enjoy nerdy conversation about subpar medical research, this is your luck day.
status epilepticus
11 posts
Welcome back to another edition of the research roundup, where we discuss an eclectic collection of articles selected through the rigorous process of whatever I happened to find most interesting in my recent reading (with a couple suggestions from Dr. Casey Parker). The BroomeDocs podcast version can be found here: […]
Intranasal midazolam hit the scene with a lot of hype. It was fast. It was easy. As a result, it was quickly adopted into many pediatric seizure algorithms. However, the more I think about it, the more I realize that intranasal midazolam makes absolutely no sense in the management of […]
In the classic algorithm for status epilepticus, we give 2 doses of a benzodiazepine followed by phenytoin. Since the introduction of levetiracetam, we have seen a lot of strong opinions about the best second line agent, but we never had much data. (I have argued that we actually need to […]
Here is another collection of the articles I have found interesting in my reading from the last month or so. For this edition of the Research Roundup we have status epilepticus, nocebos, the pink lady, McGyver bias, and so much more. Podcast version over on BroomeDocs.
This will be the final post this week about status epilepticus. I have long argued that our current status algorithms leave too many patients seizing for too long. I updated my suggested alternative algorithm this week and added a longer supplemental post explaining the reasons that I suggest early anesthetic […]
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 […]