Round 9 (Seizure)

EM Clerkship - A podcast by Zack Olson, MD and Michael Estephan, MD

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CAUTION: THESE NOTES CONTAIN SPOILERS!!! Case Introduction The nurse brings back a young adult male from the lobby who is having a seizure… Initial Vitals * Temp 98.8* HR 90* RR 10* BP 120/80* O2 92% Critical Actions * Verbalize ABCs on a Critical Patient* Obtain Immediate Blood Glucose Level* Give Benzodiazepine* Initiate Workup of New-Onset Seizures* Give Pyridoxine (Vitamin B6) Final Diagnosis Isoniazid Toxicity Tips and Tricks When the patient is unable to provide history, attempt to obtain the information from external sources Additional Reading * Isoniazid toxicity overview (Life in the Fast Lane)* Basic approach to seizures (EM Clerkship)* Basic approach to status epilepticus (EM Clerkship)* Ketamine for refractory status epilepticus (PubMed) Corrections Ketamine not Keppra as potential induction agent for status epilepticus (32:40)