Seizure Mimics
The pediatric patient with seizure, or is it really a seizure? A host of other conditions can look just like seizure. This Peds EM Morsel provides you with some answers.
Neurology
A Simplified Approach to the Patient with Dizziness
Dizziness is a common chief complaint with a large differential ranging from benign to a life-threatening bleed. How should you approach the patient with dizziness, and what do you need to consider?
A Simplified Approach to the Patient with Dizziness Read More »
Stroke Mimics: Pearls and Pitfalls
A stroke mimic is defined as a nonvascular disease that presents with stroke-like symptoms, often indistinguishable from an actual stroke. Why does it matter if a mimic is diagnosed as a stroke? Learn the pearls and pitfalls of stroke mimics.
Stroke Mimics: Pearls and Pitfalls Read More »
Undifferentiated Weakness: ED-Focused Approach and Management
Weakness is a challenging chief complaint. Always consider the common etiologies such as urinary tract infections. However, debilitating spinal cord pathology and other rare causes of weakness should be ruled out in otherwise negative work ups.
Undifferentiated Weakness: ED-Focused Approach and Management Read More »
Treatment of Seizures in the Emergency Department: Pearls and Pitfalls
What do you do with the seizing patient? What tests and medications are warranted?
Treatment of Seizures in the Emergency Department: Pearls and Pitfalls Read More »
Can Giant Cell Arteritis Be Ruled Out in the ED?
Are there any tests that can help you with Giant Cell Arteritis?
Can Giant Cell Arteritis Be Ruled Out in the ED? Read More »
Serotonin Syndrome and Neuroleptic Malignant Syndrome: Pearls & Pitfalls
The hot, altered, and stiff patient. What do you need to consider?
Serotonin Syndrome and Neuroleptic Malignant Syndrome: Pearls & Pitfalls Read More »
Neuro Intubation Highlights
You are working a busy shift when you receive a phone call from EMS that they are bringing in a “sick trauma patient.” As you prepare the trauma bay, the patient arrives. He is the victim of an assault and in clear need of intubation. He is unconscious with a GCS of 5, HR 125, BP 180/11, Sp02 88% on NRB 15 lpm, RR 22. As you prepare your medications, what are the best options for this scenario? Pre-treatment with lidocaine, fentantyl or esmolol? Is it okay to use ketamine in trauma patients in traumatic brain injury (TBI)?
Neuro Intubation Highlights Read More »
Acute Ataxia in the ED Highlights
The word “ataxia”, comes from the Greek word, ” a taxis” meaning “without order or incoordination”. Learn how to evaluate and gain tips/pearls on acute ataxia in the emergency department.
Acute Ataxia in the ED Highlights Read More »
Bounceback: An Unrelenting Headache
CC: Headache
First visit
HPI: 29 year old female with a prior history of headaches, presented with two days of gradual onset, atraumatic, right sided headache that is throbbing in nature. The patient reported heaviness about the eye but no visual changes or disturbances. No neck pain, fevers, chills. She described feeling slightly light-headed but no balance loss. She had a mechanical trip and fall yesterday without head trauma, and her headache had been present for a day prior to the fall.
ROS: otherwise normal.
PMH/PSH: headaches, depression, anxiety, asthma
SH: no smoking, no etoh, no drugs
Allergies: Penicillin (rash)
Pertinent Exam
Vitals: 98.6F, BP: 156/85 P: 101, RR: 16, O2: 98%RA
Gen: A&Ox3, well-developed, well-nourished
HEENT: normocephalic, atraumatic, conjunctiva wnl, EOM wnl, PERRL, normal fundoscopic exam, crisp optic discs, normal ROM neck/supple
Chest: wnl
Abd: wnl
Musculoskeletal: wnl
Neuro: CN2-12 intact, normal reflexes, normal muscle tone, normal coordination
Labs: Serum HCG negative
Imaging: None ordered
ED Course: The patient was believed to be experiencing a migraine headache. She had no evidence of head trauma, no signs of infectious etiology, and had no clinical findings or hx for SAH. She was administered Toradol, IVF and Reglan, and discharged with instructions to follow up with neurology and possibly have an outpatient MRI.
Discharge Dx: Headache […]
Bounceback: An Unrelenting Headache Read More »