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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

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SGEM Xtra: Here Comes the NINDS Again

The Skeptics' Guide to EM

Risk of selection bias assessment in the NINDS rt-PA stroke study. Risk of selection bias assessment in the NINDS rt-PA stroke study. While this is true, we are part of the team that diagnose and treat acute stroke patients. This committee’s findings supported the use of tPA in less than three hours ( Ingall et al 2004).

Stroke 52
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The Higher Tech Kid in the ED

Pediatric Emergency Playbook

Also used for severe MS, stroke, TBI, chronic pain. 2004; 26(4): 163–167. Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study. Are VNS safe in everyday life? Verify the medication and identify the toxidrome if symptomatic. J Emerg Med.

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What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

Stroke-volume:50 ml. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease. N Engl J Med [Internet] 2013;368(21):2004–13. Left ventricular end-diastolic volume: 99 ml. Left ventricular systolic volume: 49 ml. Normal wall thickness.

EKG/ECG 109
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Diagnostics: Inflammatory Markers

Taming the SRU

Bacterial Meningitis: IDSA guidelines for 2004 report that a normal CRP value has a high negative predictive value for bacterial meningitis, but sensitivities and specificities vary between studies [35]. Incorporation of inflammatory markers into the Duke Criteria as minor criteria has been proposed, but not accepted [37]. Cleve Clin J Med.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

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SGEM#450: Try Again – Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage

The Skeptics' Guide to EM

A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. INTERACT-2 demonstrated that in patients with ICH, intensive lowering of blood pressure did not result in a significant reduction in the rate of the primary outcome of death or severe disability (SGEM#73).

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