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 93

Radiology Radiology Stroke Hospitals 93

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. 2011; 7:491-500. Journal of Chemical Neuroanatomy; 2011; 42: 288–296. 2011; 58(11):1183–90 Fraser CD, Jaquiss RDB, Rosenthal DN et al. Are VNS safe in everyday life? Verify the medication and identify the toxidrome if symptomatic. J Neurosurg Pediatrics. 2015; 4, Art.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Pediatric Emergency Playbook

AUGUST 1, 2020

Pediatrics 2011; 128:e741. Heat illness and heat stroke. Council on Sports Medicine and Fitness and Council on School Health, Policy statement—Climatic heat stress and exercising children and adolescents. Casa DJ et al. J Athl Train. 2013 Jul-Aug; 48(4): 546–553. Hyperthermia. Jardine DS. Pediatr Rev 2007; 28:249.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Stroke Burns Pediatrics 52

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. N Engl J Med.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

RebelEM

MARCH 22, 2023

Multiple studies comparing verapamil to adenosine demonstrate equal efficacy of either agent with verapamil causing more hypotension ( Delaney 2011 , Hood 1992 ) Dose: 0.07 2011; 18(3): 148-52. Can J Cardiol 2011; 27(1): 105-9. Can J Cardiol 2011; 27(1): 105-9. Am J Emerg Med 2011; 29(5): 545-8. Eur J Emerg Med.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

Resus Review

OCTOBER 9, 2015

Left Main Treatment Advances The fundamental balance between coronary artery bypass surgery and PCI, is the tradeoff of risk of need for revascularization and embolic stroke. Surgical advancements reduced the risk of stroke including the expanding use of off-pump CAB, better vein graft patency, and widespread use of LIMA.

Stroke 52

Stroke Ultrasounds Outcomes 52

Dr. Smith's ECG Blog

AUGUST 23, 2017

Same stroke precautions as atrial fib

Stroke 52

Stroke Sepsis Emergency Department EMS 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. 2011; 76(12):1071-7 Baren J. Pediatric Seizures and Strokes: Beyond Benzos and Brain Scans. Nonconvulsive seizures are common in critically ill children. ACEP Scientific Assembly.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. 2011 Jan;3(1):118-27. 2011 Aug;18(8):781-96. 2011 Sep;18(9):1011. In: StatPearls [Internet].

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

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. 2011; 2(1):70-72. 2011 Jan-Jun; 4(1): 81–83. 2011; 32:492-497. 2011; 552-555. 2011; 128(6):1-6 Munk K et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2016

Conversely, is the heart rate too slow – even if the stroke volume is sufficient, if there is severe bradycardia, then cardiac output -- which is in liters/min – is decreased. 2011; Apr 26;123(16):1788-830. 2011; 39:450. If so, use 1 J/kg to synchronize cardiovert. Chemically pace with atropine, 0.01 mg/kg up to 0.5

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Pediatric Emergency Playbook

NOVEMBER 1, 2015

That is not usually a problem, but for those with preexisting or inducible hyperkalemia, it can precipitate an arrest, as in renal failure, underlying neurologic or myopathic conditions like multiple sclerosis, muscular dystrophy, ALS, or those who had a stroke or a burn more than 72 hours prior. Relax, it’s a myth.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

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

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 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

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. Srinivasan, A., Feber, K.M.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

The Skeptics' Guide to EM

JULY 4, 2020

hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances. Background: Thrombolysis for acute ischemic stroke has to be one of, if not the most, controversial subjects of my career. Thrombolysis in acute ischaemic stroke. EMA 2013 * The “Fragility” of Stroke Thrombolysis.

Stroke 52

Stroke Research Hospitals Emergency Department 52

Taming the SRU

APRIL 26, 2023

First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Misdiagnosis of exertional heat stroke and improper medical treatment. Mil Med 2011. Cooling Methods in Heat Stroke. Resuscitation 2020. Druyan A, Janovich R, Heled Y. Epstein Y, Yanovich R. Heatstroke.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. neutropenia) ( Babl 2011 , Dokko 2014 ). 2011 Jun;27(6):496-9. Louis, Mo: Mosby; 2011. As clinicians we can target specific “stations” along the pain route to target the signal more effectively. Acad Emerg Med. Pediatr Emerg Care.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9% 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Dr. Smith's ECG Blog

DECEMBER 5, 2023

References Law YM, Lal AK, Chen S, Čiháková D, Cooper LT Jr, Deshpande S, Godown J, Grosse-Wortmann L, Robinson JD, Towbin JA; American Heart Association Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young and Stroke Council. Circulation. doi: 10.1161/CIR.0000000000001001.

Pediatrics 121

Pediatrics EKG/ECG Hospitals Burns 121

RebelEM

DECEMBER 4, 2024

Cardioversion recommendations exclude patients with recent strokes or valvular heart disease. MD Calc: CHA2DS2-VASc for Atrial Fibrillation Stroke Risk References Yealy D, Kosowsky JM: Dysrhythmias, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Louis, Mosby, Inc.,

Emergency Department 96

Emergency Department Stroke EMS Shock 96

EMDocs

APRIL 1, 2025

Pneumonia and empyema may occur; intracranial involvement may lead to stroke, brain abscess, subdural empyema, meningitis, encephalitis. 2011 Aug 10;2011(8):CD002005. Mental status changes, seizures, focal deficit may occur. Other issues: Thrombophlebitis may spread to the internal jugular vein (Lemierres syndrome). Neuroophthalmology.

Dehydration 95

Dehydration Sepsis Seizures Resuscitation 95

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Papers I reviewed include ( Poudel et al Cureus 15(6): e40045, 2023 ) ( Chatterjee Neth Heart J 19:31-34, 2011 ) ( Yogendranathan et al BMC Cardiovasc Dis 17(91)- 2017 ) ( Ibrahim and Macdonald Stroke 43(8): 2102-2107, 2012 ) ( Levis Permanente J 21:16-049, 2017 ).

EKG/ECG 89

EKG/ECG Resuscitation EMS Seizures 89

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. 2011 Jul;33(5):433-60. Symptoms: Personality change (i.e., Am J Dermatopathol.

EMS 115

EMS Infectious Diseases CDC Research 115