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7 Cards in this Set

  • Front
  • Back
What are the 4 neurological emergencies?
*Convulsive Status Epilepticus
*Cord compression
*Acute bacterial meningitis
*Increased intracranial press.
what labs should be ordered if convulsive status epilepticus is suspected?
fingerstick glucose,CBC, electrolytes, AED levels
What is the rx for convulsive status epilepticus?
*ABCs
*oxygen - 4LNC
*pulse ox - > 92% consider intubation
*IV access
*Ativan (.1mg/kg) or Valium (.25mg/kg) IV over 10 minutes
*Phenytoin or Phosphenytoin (20mg/kg) IV at a max rate of 50mg/min
*consider elective intubation
*Phenobarbital (20mg/kg) IV at a max rate of 100mg/min
*transfer to ICU for central line and phenobarb drip
What are the causes of cord compression?
*trauma
*cancer
What are symptoms of cord compression?
Back pain +/- fever, leg weakness or numbness
Describe the physical exam during cord compression.
*reflexes usually increased, but may be decreased acutely (spinal shock)
*toes ussually up-going or silent, rarely down-going
*tone usually increased but may be decreased acutely (spinal shock)
*pyramidal weakness in the legs or all 4 limbs)
*pin level
*Reduced anal wink
*absent superficial abdominal reflexes
What test should be ordered if spinal cord compression is suspected?
*plain films of the spine
*MRI of C and T spine
*Myelography (LP w/ radio-opaque die injected)