Remove 2000 Remove Stroke Remove Wellness
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Grand Rounds Recap 11.29.23

Taming the SRU

Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH. Posterior circulation stroke Patients with posterior strokes will likely have a low NIH. Involve the stroke team if posterior circulation stroke is suspected, as they may be a candidate for TNK, or more rarely, EVT.

Stroke 53
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Doing statistics can be difficult but understanding them can be fairly simple

Sensible Medicine

Back to the Trial With proper randomization, the two groups should be well balanced with regard to baseline characteristics and therefore have no notable sources of bias and confounding. if the risk of heart attacks/strokes in each group was the same, say, 10%, then the risk ratio, 10%/10% = 1. A CVD event occurred in 17.8%

Outcomes 119
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Episode 31 - Emergency Department Management of Patients Taking Direct Oral Anticoagulant Agents (Pharmacology CME)

EB Medicine

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Nachi: Well, I’m sure more of those studies are still coming. Show More v Jeff: Fair enough, we’ll take what we can get. Jeff: Agree.

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Diagnostics: Inflammatory Markers

Taming the SRU

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 2000 Aug;30(1):17-24. They are used clinically to detect pathological inflammation or measure response to treatment [1-2]. Semin Arthritis Rheum. doi: 10.1053/sarh.2000.8366. PMID: 10966209.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

PubMed: 29631516] van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the Glasgow Coma Scale. 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345. 107.498345. Epub 2008 Feb 28. PMID: 18309166. 2019): 478–483. Ash, Kristian et al. 2018): 192–200.

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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

These patients can have a vasodilated vascular bed and the initial use of fluids is hypothesized to serve two purposes: Augmenting the macrovascular system (stroke volume and cardiac output) and augmenting the microvascular perfusion (capillary blood flow). Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4 Read more

Sepsis 103
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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented.