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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.

Stroke 73
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 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.

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

Taming the SRU

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., Tunkel, A. Hartman, B. Kaplan, S.

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

Dr. Smith's ECG Blog

Assuming the heart rate is not too rapid ( this method works less well with heart rates >90-100/minute ) — one may suspect that the QTc will be long if the longest QT interval that you can clearly see on the tracing is more than half the R-R interval. Trostel and Meyers — the QTc in markedly prolonged in today's case.

EKG/ECG 112
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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

Over some time and the pain moved into her other arm as well as her jaw. Stroke-volume:50 ml. N Engl J Med [Internet] 2013;368(21):2004–13. Over the course of the next hour, this pain turned into a pressure in her chest. She said this was midsternal and felt like a tightness. This originally radiated into her left arm.

EKG/ECG 102
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MI in Children

Pediatric Emergency Playbook

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

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Please STOP LIMPING!

Pediatric Emergency Playbook

Lab work can be helpful, as well as US of the hip to look for an effusion, but sometimes, regardless of the results, the joint just has to be tapped to know for sure. If you have any suspicion of the general wellness of the child, get a screening CBC, and perhaps a peripheral blood smear. These children don’t look to well.