NeuroMuscular Emergencies

IMPORTANT: This app is intended for use by qualified healthcare professionals only. Always seek the advice of a qualified clinician before making any medical or prescribing decisions.

Neuromuscular Emergencies is a comprehensive evidence-based reference for the recognition and management of acute neuromuscular conditions. Built for neurologists, intensivists, emergency physicians, and allied health professionals managing patients with neuromuscular respiratory failure.

GUILLAIN-BARRE SYNDROME
- Brighton diagnostic criteria and clinical features
- GBS disability scale and IGOS prognosis score
- IVIg protocol: 0.4g/kg/day for 5 days with full administration guide
- Plasma exchange protocol: 200-250 mL/kg over 5 sessions
- Six GBS variants: AIDP, MFS, AMAN, AMSAN, PCB, pure sensory
- Anti-GQ1b, anti-GM1, anti-GD1a antibody significance
- Supportive care: autonomic monitoring, pain management, VTE prophylaxis
- Anti-ganglioside antibody guide and variant recognition

MYASTHENIC CRISIS
- Recognition of impending respiratory failure: single breath count, paradoxical breathing
- Myasthenic vs cholinergic crisis - SLUDGE, pupil changes, clinical comparison table
- 20/30/15 rule: VC below 20, NIF below -30, MEP below 40
- IVIg and plasma exchange protocols - MGTX trial evidence
- Pyridostigmine hold during ICU admission
- New agents: eculizumab (NICE approved), efgartigimod
- Intubation considerations

RESPIRATORY FAILURE IN NM DISEASE
- 20/30/40 rule - visual dashboard of critical thresholds
- Why SpO2 is unreliable in neuromuscular respiratory failure
- Bedside vital capacity technique - 6-step protocol
- Serial NIF measurement technique
- Intubation criteria and weaning criteria
- Peak cough flow assessment

LAMBERT-EATON MYASTHENIC SYNDROME
- LEMS vs MG clinical comparison table
- Anti-VGCC antibody - pathophysiology and diagnosis
- EMG pattern: incremental response at high-frequency stimulation
- 3,4-Diaminopyridine (amifampridine) dosing and mechanism
- Malignancy screen protocol - SCLC association

BOTULISM
- Five types: foodborne, wound, infantile, iatrogenic, inhalation
- Four Ds: diplopia, dysarthria, dysphagia, descending paralysis
- Fixed dilated pupils - key distinguishing feature
- 7-step emergency protocol including PHE contact number
- Heptavalent antitoxin - administration and timing
- Wound debridement for injection drug use botulism

CRITICAL ILL