We encounter seizure disorders frequently in the ED.  In this episode, we'll review all the important points about seizures including the confusing and difficult topic of pseudosezures.  We'll also go in depth on the ED treatment of seizures and status epilepticus.

We're back with a new episode of Essential Evidence.  This article is from Academic Emergency Medicine March 2009 and it talks about getting blood cultures in well appearing kids aged 3 to 36 months.  We used to get a lot of blood cultures in these well appearing kids with fever but this article was the final nail in the coffin that got us to stop doing that.  It's hard to believe that based on how we practice now but we needed this large study to show us that we are now doing the right thing.

EM Basic is back and ready for the new year.  We see various eye complaints a lot in the ED.  This episode will review common eye complaints, their treatments, and a bonus section on how to do a lateral canthotomy.

This episode reviews the article that most people call the PECARN head CT rule or the Kupperman head CT rule (named for the first author). This is an easy to use clinical decision rule that can help us reduce the number of head CTs that we do on children with minor head injury. We owe it to our patients to spare them excess radiation, cost, and time in the ED and this rules helps us do this. In order to use this rule effectively, you need to read this article and understand how the study was done.  This allows us to understand the strengths and weaknesses of this rule and helps us apply it in our everyday practice.

This episode of EM Basic Essential Evidence will review the two articles that led to the adoption of therapeutic hypothermia as a treatment for survivors of cardiac arrest. This is a simple yet highly effective therapy that improves survival and neurological outcome in survivors of cardiac arrest so it is important that we know and understand these two articles.

This is an article published in the last year in the British Medical Journal that looked at the sensitivity of modern CT scanners in detecting subarachnoid hemorrhage. This article made a lot of waves because it suggested that a head CT within 6 hours of headache onset is 100% sensitive for subarachnoid hemorrhage.  Some have called it a practice changer that allows us to avoid doing a lumbar puncture so its important to read it for yourself and decide if it should change your practice.

Non-invasive ventilation is a great technique that we can use for just about any patient who is short of breath.  We can use it to avoid intubation in our patients who are close to respiratory failure.  In this episode, we'll talk about how non-invasive ventilation works, which patients we can use it on, and how to actually make it happen.  For that last part, I'll borrow from a post by Seth Treuger at his blog mdaware.org on how to start non-invasive ventilation quickly while keeping it comfortable for the patient.

This episode will discuss the NEXUS study.  NEXUS was a study that studied thousands of patients to validate a set of rules so that we can "clinically clear" patients with possible c-spine injury without getting an x-ray. This study has helped us avoid radiation in certain low-risk patients, saved the cost of x-rays and CT scans, and speed these patients through the ED. We'll talk a lot about the statistical side of this study and how you can apply it in your everyday practice.

All right- let's keep the laughter to a minimum...today's episode is talking about how to approach testicular pain in the ED.  You need to know how to approach this chief complaint because if you don't workup the patient correctly, they can lose their future fertility and possibly their testicle.  We'll review how to take a good history and do a rapid focused exam to make sure that we catch all those patients with torsion and don't delay their treatment.