Seizures

We encounter seizure disorders frequently in the ED.  In this episode, we’ll review all the important points about seizures including the confusing and difficult topic of pseudosezures.  We’ll also go in depth on the ED treatment of seizures and status epilepticus.

Seizures podcast

Seizures Show Notes (Word Format)

Seizures Show Notes (PDF)

Links mentioned in the podcast

Rapid oral loading of Phenytoin (dilantin) from Academic Life in Emergency Medicine

Status epilepticus algorithm pocket guide (pediatric but it works for adults too)

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4 Comments on “Seizures”

  1. Max says:

    I have always been under the impression that the administration of hypertonic saline via the IO route was contraindicated for fear of “high rate of local complications,” as in this study:

    http://www.ncbi.nlm.nih.gov/pubmed/11791047

    It has also been recommended against by Dr. Jeff Guy (ICU Rounds podcast), at least in his book Pharmacology for the Prehospital Professional.

    As always, thanks for the podcast and keep up the good work!

    • EM Basic says:

      Hey Max

      After putting the question out there to Twitter- the consensus is that everyone I talked to said the concern over local complications is far outweighed by the benefit of terminating the seizure. The study that you referenced was using 7.5% saline (not sure if that makes a difference) and the complications were days afterwards. In the case of a critically ill patient with hyponatermia who was seizing and I couldn’t get IV access, I would place an IO, push enough hypertonic saline to get the seizure to stop, and then place a central line. The central line is necessary in the inpatient treatment of hyponatermia to give more hypertonic saline because it can sclerose peripheral veins if given long term. I wouldn’t leave an IO in for a long time to give the hypertonic saline- just as a bridge until I got central access.

      Thanks for commenting and bringing that point up- I always welcome different views and opinions!

      Steve

  2. […] awesome podcast, set of shownotes and links from EM Basic “Seizures”. Thanks Lauren for the tip off. […]

  3. […] Seizures - In this episode, Steve review’s all the important points about seizures including the confusing and difficult topic of pseudoseizures. […]


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