This weeks case highlights the challenges of ED management of neonatal seizures. We discussed the utility of head US vs. CT brain when able. We also discussed varying levels of comfort with doing an LP in a frequently seizing baby without respiratory symptoms or desats. We considered appropriate thresholds for AED administration in self-resolving seizures. […]
Hot Seat #263: Seize the Day
Case by Gabby Jasmin, CNH PEM Fellow You get a call about a trauma transfer from OSH. 2-week-old ex full-term female born NSVD presenting from PCPs office with concern for seizure-like activity. Mom states that episode started last week and has been increasing in frequency. She describes the movements as left arm stiffening and facial twitching. During these episodes the infant will turn very red and sometimes spit […]
Hot Seat # 262 Denouement
This weeks case highlights the challenges of clinically clearing a c-spine vs. radiographic findings. We discussed the utility of a c-collar in a toddler when you are not concerned about an unstable cervical spine injury. We also discussed the challenges of having CT information from an outside hospital in a patient you may not have […]
Hot Seat #262: A “collarly” debate
Case by Kate Ritter, CNH PEM Fellow You get a call about a trauma transfer from OSH. Patient is a 22-month-old male who was sitting in the front seat of a non-electric bike going 20 mph on a gravel trail (dad was pedaling), patient’s foot got caught in the front wheel and both patient and dad flew off bike. Patient has a “non-displaced mandibular fracture” […]
Hot Seat #261 Denouement
This weeks case highlights the challenges of interpreting an abnormal neurology exam. We discussed the inconsistencies in her exam that are not correlated with a specific neurologic pathway, however absent reflexes are never normal. We went over a wide differential and the importance of baseline NIFS. MRI completed which showed non-specific white matter lesion in […]