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Looking Past Dementia Reveals Hidden Life Threats
Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophen...
Source: JEMS Special Topics - August 13, 2018 Category: Emergency Medicine Authors: Joseph K. Mesches, NRP, FP-C Tags: Exclusive Articles Patient Care Source Type: news

Prehospital Assessment for Stroke Isn ’t Perfect
Prehospital assessment tools for neurological deficits aren’t perfect An approximately 30-year-old male answers the door to let you and your partner into the house you’ve been called to. Hank introduces himself and thanks you for coming, quickly adding that he’s concerned about his mother who’s “acting weird.” Hank tells you he stopped by his mom’s house for lunch and found her using paper plates to heat food on the stove. He stopped her before the plate ignited. His mother seemed confused and so he called 9-1-1. Patient Assessment Margaret, Hank’s 53-year-old mother, appears to be in good healt...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, EMT-P Tags: Patient Care Cardiac & Resuscitation Columns Source Type: news

Basilar artery occlusion presenting as refractory status epilepticus
We report in best of our knowledge the first case of refractory status epilepticus in the brainstem stroke and review the relevant literature. We present a case of 45-year-old hypothyroid female presented with loss of consciousness followed by generalized tonic-clonic seizures which turned out into refractory status epilepticus as benzodiazepines and antiepileptic drugs were ineffective. Magnetic resonance imaging and angiography of brain revealed basilar artery occlusion with infarcts of midbrain, bilateral thalami and cerebellum without cortical involvement. Emergency physician should be aware of this unusual presentatio...
Source: Journal of Acute Medicine - June 2, 2015 Category: Emergency Medicine Source Type: research