CritCases is a collaboration between Dr. Mike Betzner, medical director of STARS air ambulance service and EM Cases. There are many approaches and therapeutic options in critical care that do not have a strong evidence base to guide us. We use our clinical judgement, gestalt and basic principles to make rapid decisions. This blog explores therapeutic options to various challenging critical care scenarios through an interactive case-based, Q&A framework. The case unfolds in a step-wise manner, as it would in real practice, and integrates opinions from critical care providers, not only from STARS, but from around the world. Each blog includes an open peer review from an expert on the given topic. Welcome to CritCases!
In this EM Cases CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, a middle aged woman presents to a rural ED with headache and vomiting, normal vital signs with subsequent status epilepticus and serum sodium of 110 mmol/L. What management recommendations would you make to the rural ED physician, the transport team and in your ED with regards to treatment of seizures, safe correction of hyponatremia, airway management, search for underlying cause and prevention of Osmotic Demyelenation Syndrome?