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REBEL Core Cast 97.0 – Acute Vision Loss II

RebelEM

CRAO is a stroke of the eye; patients should be considered for a complete stroke work up. Retinal Detachment ( Hollands 2009 ) Pathophysiology Posterior vitreous shrinks with advancing age (aka synchysis senilis), pulling on the retina. Symptom characteristics ( Hollands 2009 ) Any flashers/floaters: (+) LR 1.2

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Grand Rounds Recap 5.22.24

Taming the SRU

Susan Wilcox Increasing regionalization due to: Growth of specialty centers Increasing development of healthcare systems Hub-and-spoke models Development of ECMO, trauma, transplant, and stroke centers The higher the acuity of the centers, the higher the acuity of the patient that needs to get there. Benefits of transport are evidenced based.

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Diagnostics: Thromboembolic Disease in Pregnancy

Taming the SRU

history of VTE, increased calf circumference, pain and swelling), then the next step is to attain a compressible ultrasound of the affected leg. However, if clinical suspicion is high enough, doppler ultrasound, MR venography, or serial compressive ultrasound imaging can all be considered. original drawing by dr zinter.

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MI in Children

Pediatric Emergency Playbook

The previously well child now decompensated: undiagnosed thrombophilia Asymptomatic patent foramen ovale (PFO) is the cause of some cases of cryptogenic vascular disease, such as stroke and MI. 2009; 8:67-69. Cardiovasculr Ultrasound. 2009; 24:156-8. 2009; 27:942-947. 2004; 90:e17. Canale LS et al. Güvenç O et al.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients Arch Intern Med 2009 Jul 27; 169:1299-1305.

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Pediatric Pain

Pediatric Emergency Playbook

Further, children participate in and absorb their family’s culture and specific personality from a very young age ( Finley 2009 ). Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. 2009 Aug 20;361(8):827-8. Knowing the context of the episode may help. Ann Emerg Med. 2004 Feb;43(2):256-62.

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CT Angiography Head and Neck: Indications and Limitations

EMDocs

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. Stroke Authors’ Recommendation: CTA head/neck should be acquired in patients with stroke symptoms presenting within 24 hours of symptom onset.

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