emDOCs.net Emergency Medicine (EM) Podcast
Episode 86: Tricky Cases Part 2
Sep 19, 2023
This podcast delves into tricky emergency medicine cases, including non-convulsive status epilepticus management challenges and complex airway issues. They also discuss a challenging case with ST depressions and tall T-waves, sparking a debate on urgent interventions. The importance of recognizing STEMI equivalents in acute coronary occlusion is emphasized, along with exploring ACC guidelines for such markers.
12:57
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Quick takeaways
- Non-convulsive status epilepticus can be identified by ocular movement abnormalities, emphasizing the importance of thorough observation.
- Airway management in complex cases requires a detailed plan and consideration of different tools, like video scopes and bougie, for successful intubation.
Deep dives
Identifying Non-Convulsive Status Epilepticus
Non-convulsive status epilepticus can be a challenging diagnosis in the ED, occurring in up to 50% of patients with coma or convulsive status. The condition involves ongoing or intermittent seizure activity without convulsions lasting over 10 minutes. Signs like sustained eye deviation, nystagmus, lip smacking, and subtle motor twitches may indicate non-convulsive status. Specificity of ocular movement abnormalities in diagnosing non-convulsive status can exceed 80%, making them crucial indicators to consider.
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