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For undifferentiated strokes, should blood pressure be aggressively managed pre-hospital?

PulmCCM

Uncontrolled hypertension is a major risk factor for both ischemic and hemorrhagic strokes. Maintaining blood pressure at or near the normal range (again, over long periods) reduces the risk of stroke. Once an acute stroke is underway, however, the calculus changes.

Stroke 52
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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. Initial evaluation by medics revealed right arm weakness, a right facial droop, and decreased responsiveness. When he arrives at your ED, the family tells you he was doing fine until dinner.

Stroke 72
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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). PMID: 21422387 Wan S et al. PMID: 15262836 Sharifi M et al. PMID: 27422214 Wang C et al.

Stroke 130
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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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A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

Which of the 3 Causes in the above LIST are Likely? Actually — each of the above causes in my LIST may be contributing to the markedly prolonged QTc in today's case. LYTES — All 3 of the electrolyte disturbances cited by Drs. Trostel and Meyers have been associated with QTc prolongation ( ie, hypokalemia, hypomagnesemia and hypocalcemia ).

EKG/ECG 127
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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. Are VNS safe in everyday life? Intrathecal Pumps Used to infuse basal rate of drug, usually baclofen for spasticity, but pump may contain morphine, bupivicaine, clonidine. Verify the medication and identify the toxidrome if symptomatic. Childs Nerv Syst.

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases , 22 Suppl 3 , S37–S62. Tunkel, A. Hartman, B. Kaplan, S. Kaufman, B. Scheld, W. M., & Whitley, R. Practice guidelines for the management of bacterial meningitis.