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(1145)

Podcast 663:  Down Syndrome

Podcast 663: Down Syndrome

Contributor:  Alicia Oberle, MD Educational Pearls: Down Syndrome with Trisomy 21 have three copies of chromosome 21 Current birth rates are around 1 in 700 births  Average life span 25 years in 1980...

26 Apr 20213min

UnfilterED #13: Dr. Nadia Tremonti

UnfilterED #13: Dr. Nadia Tremonti

This week's episode features a fascinating conversation with Dr. Nadia Tremonti, medical director for the pediatric palliative care program at Children's Hospital of Michigan in Detroit. Dr. Tremonti ...

22 Apr 20211h 3min

Podcast 662: Droperidol for Sedation

Podcast 662: Droperidol for Sedation

Contributor:  Aaron Lessen, MD Educational Pearls: Droperidol for sedation in agitated patients in the emergency department was studied compared to ziprasidone (Geodon) and lorazepam (Ativan) Double-...

21 Apr 20213min

Podcast 661: Scalded Skin Syndrome

Podcast 661: Scalded Skin Syndrome

Contributor:  Ricky Dhaliwal, MD Educational Pearls: Primarily affects children Caused by staph aureus releasing exotoxins that result in erythema and sloughing of the skin Present with significant ...

20 Apr 20212min

Podcast 660: Rhabdomyolysis

Podcast 660: Rhabdomyolysis

Contributor: Ricky Dhaliwal, MD Educational Pearls: Rhabdomyolysis occurs when high levels of myoglobin are released from dying muscle tissue into the blood Severe levels of myoglobin cause renal in...

19 Apr 20215min

Podcast 659: Racial Bias in Pulse Oximetry

Podcast 659: Racial Bias in Pulse Oximetry

Contributor:  Aaron Lessen, MD Educational Pearls: Study in NEJM looked at occult hypoxemia, when oxygen saturation reads at >92% when the actual saturation is Rate of occult hypoxemia was 3 times h...

14 Apr 20213min

Podcast 658: Febrile Seizures

Podcast 658: Febrile Seizures

Contributor: Peter Bakes, MD Educational Pearls: Febrile Seizure clinical criteria 6 months - 5 years of age Rapid rise in temp No preexisting seizure disorder No other explanation for the seizure...

13 Apr 20214min

Podcast 657: Caustic Ingestion

Podcast 657: Caustic Ingestion

Contributor: Aaron Lessen, MD Educational Pearls: Acid and alkali ingestions have differing prognosis and immediate concerns Immediate issues can include superficial irritation, severe burns, esopha...

12 Apr 20213min

Populært innen Vitenskap

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