Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD

Educational Pearls:

  • Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus

    • Some ED protocols only give 2 mg initially

  • The maximum recommended dose of levetiracetam (Keppra) is 60 mg/kg or 4.5 g

  • In one retrospective study, only 50% of patients received the correct dose of lorazepam

    • For levetiracetam, it was only 35% of patients

  • Underdosing leads to complications

    • Higher rates of intubations

    • More likely to progress to refractory status epilepticus

References

1. Cetnarowski A, Cunningham B, Mullen C, Fowler M. Evaluation of intravenous lorazepam dosing strategies and the incidence of refractory status epilepticus. Epilepsy Res. 2023;190(November 2022):107067. doi:10.1016/j.eplepsyres.2022.107067

2. Sathe AG, Tillman H, Coles LD, et al. Underdosing of Benzodiazepines in Patients With Status Epilepticus Enrolled in Established Status Epilepticus Treatment Trial. Acad Emerg Med. 2019;26(8):940-943. doi:10.1111/acem.13811

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit

Jaksot(1144)

Podcast 848: Non-Traditional RSI

Podcast 848: Non-Traditional RSI

Contributor: Meghan Hurley, MD Educational Pearls: Two main reasons to choose non-traditional RSI Anatomically challenging airway Physiologically difficult patients: hypoxia, metabolic acidosi...

24 Huhti 20235min

Podcast 847: ECMO CPR

Podcast 847: ECMO CPR

Contributor: Aaron Lessen, MD Educational Pearls: Extracorporeal Membrane Oxygenation (ECMO) has been attempted as an adjunct to CPR during cardiac arrest but few studies on outcomes exist One prior...

6 Helmi 20233min

Podcast 846: Early Repolarization vs. Anterior STEMI

Podcast 846: Early Repolarization vs. Anterior STEMI

Contributor: Travis Barlock, MD Educational Pearls: Early repolarization a benign EKG pattern that can mimic an anterior STEMI Can be seen in the anterior leads typically in young male patients Can d...

30 Tammi 20232min

Podcast 845: Hyperkalemic Cardiac Arrest

Podcast 845: Hyperkalemic Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including ...

16 Tammi 20234min

Podcast 844: Dental Infections

Podcast 844: Dental Infections

Contributor: Meghan Hurley, MD Educational Pearls: Educational Pearls: Dental infections can be categorized into two main groups Infections of the gums Pericoronitis Tooth eruption leading to infl...

10 Tammi 20234min

Podcast 843: Commotio Cordis

Podcast 843: Commotio Cordis

Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest A national registry, US Commotio Cordis Registry, repor...

9 Tammi 20234min

Podcast 842: "History of Wound Care"

Podcast 842: "History of Wound Care"

Contributor: Chris Holmes, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided ...

4 Tammi 20234min

Podcast 841: Wound Care

Podcast 841: Wound Care

Contributor: Aaron Lessen, MD Educational Pearls: Wound care in the emergency department aims to prevent future infection Copious wound irrigation is the important step in preventing wound infection ...

3 Tammi 20233min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
tiedekulma-podcast
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
filocast-filosofian-perusteet
rss-laakaripodi
rss-opeklubi
rss-lihavuudesta-podcast
rss-sosiopodi
sotataidon-ytimessa
mielipaivakirja
radio-antro
rss-radplus
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita