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

Episoder(1144)

Podcast 840: Abnormal Pediatric Vitals at Discharge

Podcast 840: Abnormal Pediatric Vitals at Discharge

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric patients frequently have vital signs considered abnormal for age at discharge Large multicenter study recently evaluated if pediatric patie...

29 Des 20223min

Podcast 839: Causes of Pancreatitis

Podcast 839: Causes of Pancreatitis

Contributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: "GET SMASHED" G: Gallstones (Most common cause of pancreatitis overall) E: Ethan...

19 Des 20223min

Podcast 838: Sternoclavicular Septic Arthritis

Podcast 838: Sternoclavicular Septic Arthritis

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis of the sternoclavicular joint is uncommon accounting for Immunosuppression and IV drug use increases the risk  Can account for up ...

13 Des 20224min

Podcast 837: Snakebites

Podcast 837: Snakebites

Contributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten ex...

12 Des 20226min

Podcast 836: Humming to get EJ

Podcast 836: Humming to get EJ

Contributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg's position and Valsalva's maneuver by patient One stu...

6 Des 20223min

Podcast 835: Syncope Review

Podcast 835: Syncope Review

Contributor: Meghan Hurley, MD Educational Pearls: Syncope is defined as a loss of consciousness with an immediate return to baseline Differential is broad Cardiogenic Structural (aortic stenosis, ...

5 Des 20226min

Podcast 834:  Peds Buckle Fractures

Podcast 834: Peds Buckle Fractures

Contributor: Aaron Lessen, MD Educational Pearls: Torus (Buckle) fractures are a commonly encountered pediatric fracture pattern Typically presents as wrist pain secondary to a child falling on outs...

29 Nov 20223min

Podcast 833: NS vs LR

Podcast 833: NS vs LR

Contributor: Travis Barlock, MD Educational Pearls: Normal Saline (NS) contains 154 mEq of both Sodium (Na) and Chloride (Cl), and has a pH of 5.5 Normal Na and Cl in adult humans are about 140 mEq...

28 Nov 20225min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
smart-forklart
jss
sinnsyn
rekommandert
rss-rekommandert
villmarksliv
tomprat-med-gunnar-tjomlid
forskningno
rss-paradigmepodden
fjellsportpodden
aldring-og-helse-podden
tidlose-historier
diagnose
pod-britannia
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
nevropodden
dekodet-2