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

Avsnitt(1144)

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral ed...

3 Feb 20253min

Episode 941: Rehydration in Pediatric Gastroenteritis

Episode 941: Rehydration in Pediatric Gastroenteritis

Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of diffe...

27 Jan 20253min

Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves need...

20 Jan 20252min

Episode 939: Serotonin Syndrome

Episode 939: Serotonin Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications...

13 Jan 20253min

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Contributor: Aaron Lessen, MD Educational Pearls: Many patients present to the ED with elevated BP Many are referred from outpatient surgery centers or present after an elevated measurement at ho...

6 Jan 20252min

Episode 937: Pneumomediastinum

Episode 937: Pneumomediastinum

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, a...

30 Dec 20245min

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adver...

23 Dec 20244min

Episode 935: Pregnancy Extremis - TOLDD

Episode 935: Pregnancy Extremis - TOLDD

Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriat...

16 Dec 20243min

Populärt inom Vetenskap

p3-dystopia
svd-nyhetsartiklar
dumma-manniskor
pojkmottagningen
allt-du-velat-veta
det-morka-psyket
kapitalet-en-podd-om-ekonomi
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion
rss-vetenskapsradion-2
sexet
medicinvetarna
halsorevolutionen
paranormalt-med-caroline-giertz
4health-med-anna-sparre
dumforklarat
rss-spraket
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
bildningspodden
hacka-livet