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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). It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. WHO - Who Needs an LP in the ED?

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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

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% Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7).

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The Higher Tech Kid in the ED

Pediatric Emergency Playbook

Also used for severe MS, stroke, TBI, chronic pain. 2010; 30:76–81. Ultrasound-guided refilling of an intrathecal baclofen pump—a case report. 2010; 6: 46-53. Are VNS safe in everyday life? Verify the medication and identify the toxidrome if symptomatic. J Pediatr Orthop. Ghosh D, Mainali G, Khera J, Luciano M.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

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.[

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Episode 31 - Emergency Department Management of Patients Taking Direct Oral Anticoagulant Agents (Pharmacology CME)

EB Medicine

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.

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Pediatric Pain

Pediatric Emergency Playbook

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 ).

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

RebelEM

CHEST 2010. Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study.

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