Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. What is the role of transcranial dopplers in primary prevention of strokes? What strategies are useful for secondary stroke prevention?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

All Ohio EM

SEPTEMBER 16, 2019

Study Overview: INTERACT2 was a prospective, randomized, open-treatment, blinded end-point trial which was the follow-up study to INTERACT, published in 2010. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Delusions of benefit in the International Stroke Trial.

Stroke 40

Stroke Outcomes Research Hospitals 40

The Skeptics' Guide to EM

MAY 30, 2020

It seems to work for epistaxis ( SGEM#53 and SGEM#210 ), failed to demonstrate a decrease in all-cause mortality in post-partum hemorrhage ( SGEM#214 ), and did not result in an improved neurologic outcome in hemorrhagic strokes ( SGEM#236 ). This study published in 2010 showed an absolute mortality reduction of 1.5%

Head Injuries 52

Head Injuries Academics Outcomes EMS 52

RebelEM

JUNE 19, 2023

SBP < 75 mm Hg: 39% SBP 76-89 mm Hg: 33% Critical Findings: No statistically significant difference in safety outcomes (DVT, PE, MI, Stroke) TXA Placebo RR (95% CI) Primary Outcome Good Functional Outcome (6 months) 53.7% Lancet 2010; 376(9734): 23-32. Majority of patients (92%) had blunt trauma. 0.94) Mortality 28d 17.3%

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

Sensible Medicine

APRIL 16, 2024

The only problem is that all these people were smokers, and they were not being followed for major adverse cardiovascular events (cardiovascular death, nonfatal MI, nonfatal stroke, or hospitalization for unstable angina -- MACE) which is what we use ASCVD to predict.

Radiology 77

Radiology Radiology Stroke Hospitals 77

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. 2010; 30:76–81. 2010; 6: 46-53. 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.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

PulmCCM

JANUARY 22, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e.,

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

Taming the SRU

FEBRUARY 12, 2024

DISCUSSION Epidemiology and Background Rivaroxaban, along with other direct oral anticoagulants (DOACs), has become a mainstay of treatment for pro-thrombotic conditions since 2011. [1] 3-5] From a patient perspective, DOACs are favorable for daily dosing, oral intake, and lack of frequent clinical visits for dosing adjustments. May 2; 19(1): 19.

Administration 79

Administration Fractures Anaphylaxis Head Injuries 79

RebelEM

MARCH 22, 2023

2010, (Ch) 79: p 1034-63. Valsalva maneuvers Have patient bear down as if they are having a bowel movement Have patient blow as hard as they can into a straw Syringe technique Postural Modification Success rate: 43% vs. 17% (standard Valsalva) (Appleboam 2015) Details of technique found at the St. Louis, Mosby, Inc.,

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

PulmCCM

JANUARY 24, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Case 3: Headache and Arteriovenous Malformation Unlike in adults, stroke in children is divided evenly between hemorrhagic and ischemic etiologies. Pediatric Seizures and Strokes: Beyond Benzos and Brain Scans. 2010; 26(5):380-1. Nonconvulsive seizures are common in critically ill children. 2011; 76(12):1071-7 Baren J.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2022

Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. 2010 Mar-Apr;43(2):144-5. What do you think?

EKG/ECG 52

EKG/ECG Stroke Emergency Department Wellness 52

Pediatric Emergency Playbook

MAY 1, 2016

For altered adults, use AEIOU TIPS (Alcohol-Epilepsy-Insulin-Overdose-Uremia-Trauma-Infection-Psychosis-Stroke). 2010 May-Jun; 15(5): 263–265. Keep your mind open to the possibilities, and be ready to change it, when new information becomes available. Try this for altered children: remember that they need their VITAMINS! N Engl J Med.

Seizures 40

Seizures Sepsis Stroke Pediatrics 40

Downeast Emergency Medicine

APRIL 26, 2021

MI or stroke). Secondary outcomes were early head injury related death (within 24 hours after injury), all-cause and cause-specific mortality, disability, vascular occlusive events (MI, stroke, DVT, PE), seizures, complications, neurosurgery, days of ICU care, and adverse events within 28 days. Lancet 2010; 376:23-32.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

EB Medicine

AUGUST 6, 2019

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Assessing and managing children’s pain can be challenging, because they may not exhibit typically recognized signs and symptoms ( Srouji 2010 ). The Baker-Wong FACES Pain Rating scale ( Figure 1 ) was developed with feedback from children and has been validated for use in those 3 years of age and older ( Keck 1996 , Tomlinson 2010 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

DECEMBER 16, 2023

Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g., C, and heat stroke occurs at a core temperature > 40°C. C, and heat stroke occurs at a core temperature > 40°C. Temps greater than 41.5C Bendall, J.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

Pediatric Emergency Playbook

JUNE 1, 2017

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. 2010; 12(3): 3–8. 2010 Oct 1;33(10):821-42. However, the presence of PFO alone does not connote higher risk. Cardiovasculr Ultrasound.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Taming the SRU

AUGUST 30, 2023

Critical Care Medicine 38():p S26-S34, February 2010. | N Engl J Med. 2023 Feb 2;388(5):439-452. doi: 10.1056/NEJMra2206346. PMID: 36724330; PMCID: PMC9912245. Levi, Marcel MD, PhD; van der Poll, Tom MD, PhD. Inflammation and coagulation. DOI: 10.1097/CCM.0b013e3181c98d21 0b013e3181c98d21 Tanaka T, Narazaki M, Kishimoto T.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

ACEP Now

NOVEMBER 7, 2023

Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines. References Go AS, Mozaffarian D, Roger VL, et al. Circulation. 2014;129(3):e28-e292. 2018;13(9):e0204169.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Don't Forget the Bubbles

FEBRUARY 7, 2024

“Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. The cremasteric reflex The cremasteric reflex is a superficial reflex in males, triggered by lightly stroking the inner part of the thigh. The cremaster muscle contracts, elevating the testicle on that side. Beni-Israel, T., Goldman, M.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

EMDocs

NOVEMBER 2, 2024

cognitive and behavioral impairment) – 33% Ataxia – 28% Stroke – 23% Ophthalmic symptoms (e.g., The early manifestations of neurosyphilis occur during the secondary stage and include headache , meningitis , stroke , hearing loss , and ocular findings. CNS neuroscience & therapeutics 16,5 (2010): e157-68. doi:10.1001/jama.219.6.726

EMS 92

EMS Infectious Diseases CDC Research 92

EB Medicine

SEPTEMBER 1, 2018

Jeff: And to round out this section – just be aware that rare effects such as osteonecrosis, ischemic stroke, massive PE, and septic shock have all been reported. Review of eastern coral snake ( Micrurus fulvius fulvius ) exposures managed by the Florida Poison Information Center Network: 1998-2010. Position statement) 10.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EMDocs

NOVEMBER 13, 2023

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.

Stroke 86

Stroke Radiology Radiology Emergency Department 86

EB Medicine

AUGUST 1, 2018

First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA. From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled. times higher risk of stroke or TIA. Cannabis users who smoked at least once weekly had a 3.3

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

PEMBlog

MAY 9, 2024

These are expensive studies with a large amount of radiation, and in the absence of concerning signs on history in the exam, the rate of scarring abnormalities, mass, stroke, or other problems is really, really low, so like less than 1%. So in general, you don’t need a CT scan to show that the brain looks normal.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

EMDocs

NOVEMBER 4, 2024

80 It can be caused by traumatic nerve, spinal cord, or brain injury (including stroke) or can be a sequela of conditions like diabetes, HIV/AIDS, postherpetic neuropathies, multiple sclerosis, cancer, or chemotherapies. Prevalence and treatment of pain in EDs in the United States, 2000 to 2010. Am J Emerg Med. May 2014;32(5):421-31.

Emergency Department 98

Emergency Department Fractures Burns EMS 98

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 to 1.45) for fatal or nonfatal stroke.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52