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Seizures are a common presentation in the emergency department, representing up to 1% of visits to the adult ED and 2% of visits to the pediatric ED. Seizures have a wide differential and can have subtle presentations, so emergency clinicians must look for key clinical clues and utilize appropriate diagnostic studies when evaluating patients who present with seizures. This multimedia course provides an overview of the management of seizures in the ED, including the current evidence on pharmacologic management of seizures, and provides in-depth reviews of nonconvulsive status epilepticus and seizures in neonates. It includes 8.5 AMA PRA Category 1 Credits™. Included as part of the 8.5 credits, this CME activity is eligible for 5.5 Pharmacology CME credits. CME expires on 10/31/22.
Course 1: Nonconvulsive Status Epilepticus: Overlooked and Undertreated
Nonconvulsive status epilepticus (NCSE) can be a difficult diagnosis to make in the ED setting, but the key to diagnosis is a high index of suspicion coupled with rapid initiation of continuous EEG and early involvement of neurology. Benzodiazepines are the mainstay of first-line therapy, with antiepileptic drugs and anesthetics as second- and third-line therapies, respectively. The objective of this comprehensive review is to establish a standardized evidence-based protocol for the diagnosis and treatment of NCSE.
CME Credits: 4 (includes 3 Pharmacology credits)
Course 2: Seizures in Neonates: Diagnosis and Management in the Emergency Department
Neonatal seizures are associated with high morbidity and mortality, but they can be difficult to diagnose because they often present with subtle signs and symptoms. Initial management goals in the ED include patient stabilization, seizure cessation, and determination of the etiology. This course reviews common presentations and causes of neonatal seizures, considerations for ED management, and the evidence regarding antiepileptic medications for neonates.
CME Credits: 4 (includes 2 Pharmacology credits)
Video: Seizure Management in the Emergency Department
In this video, Andy Jagoda, MD, of the Icahn School of Medicine at Mount Sinai, presents an overview of the management of seizures in the ED. Following a brief review of seizure classifications, Dr. Jagoda utilizes case presentations to explore evaluation and diagnostic strategies for various types of seizures and discusses the current evidence regarding pharmacologic treatment options.
Video length: 33 minutes
CME Credits: 0.5 (includes 0.5 Pharmacology credits)
Publication Date: October 1, 2020
CME Expiration Date: October 31, 2022
CME Information: Included as part of the 8.5 credits, this CME activity is eligible for 5 Pharmacology CME credits, subject to your state and institutional approval. Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME. Credit Designation: EB Medicine designates this enduring material for a maximum of 8.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The Seizure Management in the Emergency Department course is eligible for 8 Category 2-A or 2-B credit hours by the American Osteopathic Association. The “Nonconvulsive Status Epilepticus: Overlooked and Undertreated” journal issue of Seizure Management in the Emergency Department is approved by the American College of Emergency Physicians for 4 Category I credits. The “Seizures in Neonates: Diagnosis and Management in the Emergency Department” journal issue of Seizure Management in the Emergency Department is approved by the American College of Emergency Physicians for 4 Category I credits, and has been reviewed by the American Academy of Pediatrics and is acceptable for 4 AAP credits.
Nonconvulsive Status Epilepticus: Overlooked and Undertreated:
Seizures in Neonates: Diagnosis and Management in the Emergency Department