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2 results

  • 6 - How Do I Care for Patients in the Emergency Department and Inpatient Settings?

  • Patrick Landazuri, University of Kansas Medical Centre, Nuria Lacuey Lecumberri, University of Texas Health Science Center, Houston, Laura Vilella Bertran, University of Texas Health Science Center, Houston, Mark Farrenburg, University of Kansas Medical Centre, Samden Lhatoo, University of Texas Health Science Center, Houston
  • Book:
    Seizure and Epilepsy Care
    Published online:
    28 January 2023
    Print publication:
    09 February 2023, pp 102-128

  • Summary

    A common care location for seizure and epilepsy patients is the emergency department and inpatient setting. A thorough history to discern a specific diagnosis and localization guides testing and treatment decisions. These decisions include the need for additional imaging/laboratory testing and whether to start an antiseizure medicine (ASM). Electroencephalograms (EEGs) are often required with time length depending on clinical question. If an epilepsy diagnosis is certain without clear localization, one hour of testing is preferred. If the question (or diagnosis) is status epilepticus, 24-hour EEG is indicated. For patients with known epilepsy, ASM alteration can occur for seizures with appropriate compliance. If there is noncompliance, an ASM increase may not be required. The perioperative period requires ASM continuation, although the administration route may change. Patients with renal or hepatic impairment often necessitate dose adjustment. Specific situations like alcohol withdrawal seizures have accepted paradigms to follow and are discussed. Lastly, patients in epilepsy monitoring units (EMUs) are hospitalized for diagnostic reasons with management needs different than other epilepsy patients.

  • Evaluation of COVID-19 Surveillance Strategy in Ecuador

  • Ricardo Cañizares Fuentes, Rubén Aroca, Miquel Blasco Carlos
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 16 / Issue 1 / February 2022
    Published online by Cambridge University Press:
    09 September 2020, pp. 51-54
    • Article
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  • Objectives:

    Evaluate the relevance of the coronavirus disease 2019 (COVID-19) positive case detection policy or model implemented by the Ministry of Public Health (MPH) of Ecuador and to compare it with the experiences of other countries.

    Methods:

    Data contained the daily reports publicized by the MPH. The formulations were carried out under the Conditioned Probability modality applying Bayes’ Theorem. All the COVID-19 tests applied in relation to the confirmed cases per million inhabitants were considered to obtain their level of positivity, and compared with the experience of Iceland and South Korea.

    Results:

    The probability of detecting positive cases of COVID-19 in Ecuador was higher than Iceland and South Korea, because the diagnostic tests were aimed at symptomatic patients, without identifying asymptomatic or mild symptomatic, who play an important role in the transmission of the disease. In addition, many symptomatic patients were examined but will remain undiagnosed due to the unavailability of tests and the low quality of many of them.

    Conclusions:

    The daily reports on the behavior of the COVID-19 issued by the Ecuadorian government do not adequately represent the growth in the number of those infected each day, nor the actual behavior of the epidemic, affecting possible control measures.