Effective ED management of status epilepticus includes an algorithmic approach to termination of seizures as well as management of the underlying cause: acute, nonacute, or chronic. Includes 4 AMA PRA Category 1 Credits™. CME expires on 09/01/2025

This issue discusses the presentation, diagnosis, management, and prognosis of simple febrile seizures and complex febrile seizures in children. Includes 4 AMA PRA Category 1 Credits™. CME expires on 09/01/2028

This printable PDF compiles all 42 of the 2023 issues of Points & Pearls for Emergency Medicine Practice, Pediatric Emergency Medicine Practice, and Evidence-Based Urgent Care. FREE to complete bundle subscribers. (No CME for this activity).

This issue reviews the updated International League Against Epilepsy definition of status epilepticus and discusses evidence-based medication recommendations and treatment protocols for management of pediatric status epilepticus in the emergency department. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credit, subject to your state and institutional approval. CME expires on 07/01/2028

ED management of patients with the chronic neurologic diseases, Parkinson, myasthenia gravis, and multiple sclerosis, requires targeted management strategies based on patient history and disease course. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits, subject to your state and institutional approval. CME expires on 05/01/2028

Headache is among the most common chief complaints seen in urgent care. This article reviews management strategies for primary headache disorders, which include migraine, tension-type headache, and cluster headache, as well as secondary headache disorders such as medication overuse headache. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pain Management CME credits and 2 Pharmacology CME credits. CME expires on 05/01/2025.

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence on managing mild traumatic brain injury, or concussion, in the ED. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 02/15/2028..

This issue reviews the evidence on the diagnosis and treatment of patients with suspected traumatic intracranial hemorrhage. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval. CME expires on 02/01/2028

This issue provides an evidence-based review of pediatric primary headache disorders and offers guidance for management in the emergency department. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pain Management credits and 2 Pharmacology CME credits. CME expires on 01/01/2028.

Low back pain is usually due to benign causes, but emergency clinicians must be able to identify red flag causes of pain in order to avoid patient morbidity, disability, and mortality. Includes 4 AMA PRA Category 1 Credits™. CME expires on 11/01/2027

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of stroke in the setting of drug intoxication and substance use disorder. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke credits, 2 Substance Use credits, and 1 Controlled Substances credit. CME expires on 09/15/2027.

This issue reviews the presentation, evaluation, and management of pediatric patients with COVID-19, MIS-C, and long COVID. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2027.

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the use of ultrasound in acute stroke, with a focus on applications of interest to emergency clinicians. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits. CME expires on 05/15/2027.

Many patients with low-risk electrical injuries can be safely managed in and discharged from urgent care, but clinicians must also be able to recognize high-risk injuries. Includes 4 AMA PRA Category 1 Credit™. Included as part of the 4 credits, this CME activity is eligible 4 Trauma CME credit. CME expires on 04/01/2027.

This issue reviews the definition of a brief resolved unexplained event (BRUE), summarizes the risk-stratification criteria for infants who experience a BRUE, provides management recommendations for patients with a lower-risk BRUE, and also discusses literature published since 2016 that expands on that guidance to include the higher-risk group. Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2027.

Patients who have had a COVID-19 infection may present to urgent care with a wide variety of symptoms that are associated with long COVID. This issue reviews recommendations for managing these patients based on the current state of knowledge about long COVID. Includes 4 AMA PRA Category 1 Credit™. CME expires on 03/01/2027.

The diagnostic approach to dizziness has changed from a focus on symptom quality to a timing-and triggers approach. This approach can be used in urgent care to quickly differentiate benign dizziness from deadly causes. Includes 4 AMA PRA Category 1 Credit™. Included as part of the 4 credits, this CME activity is eligible 1 Stroke CME credit. CME expires on 02/01/2027.

Patients with symptoms of long COVID may present with a wide variety of complaints that could also be potentially life-threatening non-COVID signs. What does current evidence tell us is the best way to tell the difference? Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2027.

This issue reviews the latest evidence on ED headache medications, nerve blocks, and therapies to prevent rebound headache and medication overuse headache. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits and 1 Pain Management credit, subject to your state and institutional approval. CME expires on 10/01/2026.

This issue reviews the general approach, differential diagnosis, and initial workup and management of life-threatening causes of pediatric headaches. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Stroke CME credit and 1 Pharmacology CME credit. CME expires on 05/01/2026

Managing patients with gunshot injuries depends on the location of the wounds. This issue outlines best practices for gunshot wounds to the head, neck, chest/abdomen, and extremities. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 04/01/2026.

This issue reviews acute cerebellar ataxia, anti-N-methyl-D-aspartate receptor encephalitis, and acute disseminated encephalomyelitis. The common presentations, evaluation, and management of these conditions in the emergency department are discussed. Includes 4 AMA PRA Category 1 Credits™. CME expires on 12/01/2025

Emergency Medicine Practice subscribers receive this content & CME Credit absolutely free! Log in to your subscription or subscribe now to gain instant access.

Emergency Medicine Practice subscribers receive this content & CME Credit absolutely free! Log in to your subscription or subscribe now to gain instant access.

Although rabies vaccine is rarely administered at urgent care centers, urgent care clinicians can play a role in the prevention of rabies before and after mammalian bites or exposures by identifying patients who require pre- or post-exposure prophylaxis. No CME for this activity.

This issue reviews history and physical examination findings associated with spinal epidural abscess, provides an approach to diagnostic studies, and discusses treatment options based on current evidence. No CME for this activity.

Patients with closed head injury (CHI) who present to UC require careful evaluation for any high-risk factors requiring imaging or ED transfer. This course reviews clinical guidelines and decision rules as well as recommendations for discharge. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires 05/01/2028.

When a patient presents to the ED and meningitis or encephalitis are suspected, prompt, evidence-based testing and treatment are required. No CME for this activity.

Management of the syncopal patient in the UC setting requires distinguishing life-threatening causes from benign ones. Learn the common causes of syncope and the best tools for evaluating syncopal patients. Includes 4 AMA PRA Category 1 Credits™. CME expires 4/1/2028.

This issue reviews lead poisoning in pediatric patients, including key signs and symptoms, management in the emergency department, and formulation of a safe discharge plan. No CME for this activity.

This issue reviews the performance characteristics of lactate, C-reactive protein, ferritin, and procalcitonin in potential bacterial meningitis, common bacterial infections, and appendicitis. No CME for this activity.

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) covers emergency department management of spontaneous subarachnoid hemorrhage. No CME for this activity

Cervical spine injuries can have devastating consequences, and initial ED management is critical in determining the type of injury or fracture and choosing immobilization, imaging, and referral. No CME for this activity

High-altitude illness is a spectrum of respiratory and neurologic effects resulting from hypobaric hypoxia. Swift intervention can manage these life-threatening disorders, and pretravel planning and counseling can prevent them. No CME for this activity

Identifying the cause of syncope can be difficult, but a structured ED approach can help separate life-threatening causes from benign ones, reducing hospitalizations and improving care. No CME for this activity

This issue reviews the most recent literature on mTBI and concussion and provides recommendations for the evaluation, diagnosis, and treatment of mTBI and concussion in the acute setting. Clinical decision rules and their utility in clinical practice will also be discussed. No CME for this activity

Before or after mammalian bites or exposures, rabies is completely preventable, but ED management must be timely and administered correctly. No CME for this activity

This issue reviews 3 pediatric syndromes - spina bifida, Down syndrome, and Marfan syndrome - each of which are associated with unique emergent conditions. The issue discusses the pitfalls in interpreting routine testing and reviews diagnostic and therapeutic approaches helpful in evaluating children with these syndromes. No CME for this activity

While men, women, and children who present with urinary retention require fast, effective, and comfortable relief, it is essential to investigate the cause - structural, toxicologic, neurologic, or infectious - to prevent life-threatening sequelae. No CME for this activity

This issue reviews the common presentations of Guillain-Barré syndrome and acute transverse myelitis and provides evidence-based recommendations for the workup, treatment, and disposition of patients with these syndromes. No CME for this activity

This Stroke EXTRA supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of the recognition and management in the emergency department management of blunt cerebrovascular injuries, and focuses on the appropriate diagnostic studies and stroke prevention. No CME for this activity

Life-threatening secondary headache can be due to vascular disorders or trauma, and they can present with sudden, severe onset. This course presents the red flag signs for the most dangerous causes of life-threatening headaches, with recommendations on swift imaging and treatment. No CME for this activity.

This issue reviews common presentations and causes of neonatal seizures, provides recommendations for management in the ED, and evaluates the evidence regarding antiepileptic medications for neonates. CME expired on 06/01/2023. No CME for this activity

Acute dizziness is a common presentation in the ED. Quickly differentiate the benign from the deadly with the timing-and-triggers approach to evaluation. CME expired on 12/01/2022. No CME for this activity

Altered mental status is a common presentation in the ED, and time is of the essence in diagnosing NCSE and halting seizure activity. CME expired on 10/01/2022. No CME for this activity

This EXTRA Stroke CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence and recommendations for two essential treatments for patients with acute ischemic stroke: IV thrombolysis with rt-PA and endovascular thrombectomy with stentriever. CME expired on 06/15/2022. No CME for this activity

Life-threatening secondary headache can be due to vascular disorders or trauma, and can present with sudden, severe onset. This issue presents the red flag signs for the most dangerous causes, with recommendations on swift imaging and treatment. CME expired on 02/01/2022

This issue provides guidance on how to determine whether a patient has bacterial meningitis versus viral meningitis, when a lumbar puncture is indicated, which antibiotics are recommended, and when they should be started. It also reviews evidence on the use of biomarkers such as procalcitonin to detect serious bacterial infections. CME expired on 11/1/2021 - No CME for this activity

This study guide, delivered in print, online, and audio digital formats, is designed to prepare emergency medicine physicians to pass the ABEM exams, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee. CME Expired on 06/15/2021

Differential diagnosis and treatment of pediatric syncope in the emergency department, including spotting red flags for cardiac syncope. (No CME for this activity).

Altered level of consciousness in a child can have many causes, some life-threatening. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 1/1/2020

This review discusses the limitations of routine pulse oximetry and carboxyhemoglobin measurement in determining carbon monoxide exposure, and notes effects of co-ingestions and comorbidities.

A detailed framework for the emergency physician to distinguish transient global amnesia (the acute onset of profound anterograde amnesia lasting up to 24 hours) from its most common mimics. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2019.

This study guide, available online, is designed to prepare emergency medicine physicians to pass the ABEM exam, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee. (CME expired 11/30/2023).

This issue reviews current approaches to prehospital immobilization, identification of low-risk patients who may be clinically cleared from immobilization, a rational approach to the use of radiologic imaging, and the existing evidence for medical management of spinal cord injuries.

This review summarizes the literature on complications of ventriculoperitoneal shunts, examines the literature regarding the workup and management of patients with ventriculoperitoneal shunts, and makes recommendations for the management of these patients in the emergency department.

Spontaneous intracerebral hemorrhage is a neurological emergency,made more complicated when patients are anticoagulated. Reversal of anticoagulation must be initiated simultaneously with diagnosis, treatment, and disposition. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits and 2 Pharmacology CME credits. CME expires on 12/01/2018.

Best approaches to managing common problems with enteral feeding tubes, tracheostomies, and ventricular shunts, and in sedating a pediatric patient with autism or developmental delays. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.75 Pharmacology CME credits. CME expires on 06/01/2018.

This issue of Pediatric Emergency Medicine Practice will focus on the emergency department management of seizures in pediatric patients.

This issue of Emergency Medicine Practice provides an evidence-based review of the diagnosis and management of adult patients presenting to the emergency department (ED) with seizure and SE, with a focus on the clinical situations most commonly encountered in daily practice.

This review evaluates the literature and current evidence, including controversies and recent American Heart Association guidelines, to support a best-practice approach to the diagnosis and treatment of patients with spontaneous subarachnoid hemorrhage.

A critical appraisal of the existing guidelines for the management of motor vehicle trauma and for the use of appropriate child-safety restraints is presented.

This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for pa- tients, and help manage healthcare resources and costs.

This issue reviews the broad differential of primary and secondary headaches in the pediatric emergency department, summarizes effective strategies for diagnosis, and evaluates the current evidence supporting safe, appropriate treatment.

Traumatic brain injury is the most common cause of death and disability in young people, with an annual financial burden of over $50 billion per year in the United States.

Since the 2008 issue of Emergency Medicine Practice on TIA was published, there have been numerous studies focusing on improving risk stratification and early management strategies in TIA. This update will provide the best available evidence on diagnosing and managing TIAs.

An evidence-based evaluation of various agents of procedural sedation is presented in this review.

This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care.

This issue of Emergency Medicine Practice discusses the initial workup and management of patients with primary headache disorders, with special detail to classification and medication options.

Cardiac arrest is one of the most intense clinical scenarios faced by the emergency clinician. The challenges are twofold: restarting spontaneous circulation and simultaneously attempting to find;and then reverse;the cause of the cardiac arrest.

This issue of Pediatric Emergency Medicine Practice focuses on the challenge of evaluating and treating the pediatric patient who presents with a fever and neutropenia. A discussion of chemotherapy- induced neutropenia is included in the Special Circumstances section at the end of the article.

Emergency physicians are frequently confronted with patients with neurological complaints requiring emergent imaging for diagnosis and treatment. The diversity and variations of imaging modalities may appear confusing, resulting in physician uncertainty about the most appropriate modality to evaluate the presenting complaint. An evidence-based approach, with the modality and technique selected based on patient characteristics and differential diagnosis, is essential. In this review, the evidence supporting the use of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis and treatment of emergency brain disorders will be reviewed. Adjunctive imaging techniques will also be considered, including conventional angiography, plain films, and ultrasound. Clinical decision rules intended to target imaging utilization to high-risk patients will also be discussed.