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The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

RebelEM

Background : Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. mg/kg non-inferior to alteplase in the treatment of acute ischemic stroke? vs Alteplase 34.8%

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SGEM Xtra: No Retreat, No Surrender – Thrombolysis for Acute Ischemic Stroke

The Skeptics' Guide to EM

This has been through various peer reviewed publications, doing Emergency Medicine Abstracts (EMA) audio program […] The post SGEM Xtra: No Retreat, No Surrender – Thrombolysis for Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. It appears his concerns may have come true. Six trials showed no benefit.

Stroke 52
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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 101
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Glasgow Coma Scale in Children

Pediatric EM Morsels

2005): 814–819. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. Performance of the Pediatric Glasgow Coma Scale in Children with Blunt Head Trauma.” Academic emergency medicine 12.9 Chung CY, Chen CL, Cheng PT, See LC, Tang SF, Wong AM. Critical score of Glasgow Coma Scale for pediatric traumatic brain injury. Pediatr Neurol.

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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. Reference: Garg R, Mickenautsch S. BMC Med Res Methodol. 2022 Jun 15;22(1):172. BMC Med Res Methodol.

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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

RebelEM

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Post-stroke infection: a systematic review and meta-analysis. Am J Respir Crit Care Med 2005 , 171 (4), 388-416. 4, 8 Paper: Dahyot-Fizelier, C., Infect Control Hosp Epidemiol 2014 , 35 (8), 915-936.

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The Higher Tech Kid in the ED

Pediatric Emergency Playbook

Also used for severe MS, stroke, TBI, chronic pain. 2005; 29: 493–500. 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. 2015; 4, Art.