ACEP Now

MARCH 11, 2025

2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Stubblefield WB, Helderman R, Strokes N, et al. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).

Hospitals 52

Hospitals Administration Outcomes Stroke 52

Sensible Medicine

APRIL 29, 2024

Say blueberries and rates of stroke. Then they applied the specification curve analysis to one specific database—the NHANES (National Health and Nutrition Examination Survey) from 2007 to 2014. This time in nutritional epidemiology. Take a moment and think about the methods section of a standard association study.

Stroke 142

Stroke Documentation/Coding Shock Research 142

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). CHEST 2010. PMID: 19741062 Kucher N et al. PMID: 24226805 Piazza G et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

The Skeptics' Guide to EM

MARCH 6, 2019

Shahriar also serves […] The post SGEM Xtra: Walk of Life – Thrombolysis for Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. TheNNT.com updated their website January 11th, 2019 changing the recommendation of tPA for acute stroke from RED (no benefit) to GREEN (benefit > harms). a href="[link]

Stroke 40

Stroke Academics Hospitals Outcomes 40

RebelEM

FEBRUARY 24, 2025

Of course, there are other methods of assessing fluid tolerance : Capillary refill evaluation, passive leg raise, central venous pressure measurement, pulmonary artery wedge pressures, stroke volume variation, pulse pressure variation, etc. May 2014; PMID: 24495437. Ultrasound Med Biol. Sanfilippo F, et al.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

ACEP Now

AUGUST 25, 2023

The National Heart, Lung, and Blood Institute released an expert panel report in 2014 with evidence-based guidelines for management of SCD recommending timely administration of parenteral opioids for VOE.2 Evidence-based management of sickle cell disease: Expert panel report, 2014. link] Published 2014. Am J Hematol.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

The Skeptics' Guide to EM

JUNE 17, 2023

The National Heart, Lung, and Blood Institute (NHLBI) released an expert panel report in 2014 with evidence-based guidelines for management of sickle cell disease recommending timely administration of parenteral opioids for VOE. [7] 1-6] Children with SCD presenting to the ED with VOE require timely and effective pain control.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

ACEP Now

OCTOBER 10, 2023

The CT scan reveals a hemorrhage in the right internal capsule, suggestive of acute hypertensive hemorrhagic stroke. 2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association/American Stroke Association. Published November 10, 2014. N Engl J Med.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Don't Forget the Bubbles

JUNE 30, 2023

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. 2014 Dec;77(6):852-8; discussion 858. in the TXA group vs 53.7% in the placebo group). This study moves trauma care beyond just ‘survival’. What about head injury , though? Eckert MJ, Wertin TM, Tyner SD, Nelson DW, Izenberg S, Martin MJ.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

All Ohio EM

SEPTEMBER 16, 2019

While ordinal analysis of the modified Rankin score (assessing changes along the spectrum of the mRS, as opposed to a binary good/poor outcome based on a single cutoff) has become common in stroke trials, there are questions surrounding its use. November 10, 2014 by Rory Spiegel. Delusions of benefit in the International Stroke Trial.

Stroke 40

Stroke Outcomes Research Hospitals 40

The Skeptics' Guide to EM

DECEMBER 16, 2017

This definition has been changed to a single seizure lasting more than five minutes or two or more seizures within a five-minute period without the person returning to normal between them ( Al-Mufti and Claassen Neurocritical Care Oct 2014 ). They recommend in adults without IV access to use midazolam IM. Reference: Legriel et al.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

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. Cuker A, et al.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

ACEP Now

NOVEMBER 7, 2023

Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Marco is professor of emergency medicine at Penn State Health-Milton S. Hershey Medical Center and associate editor of ACEP Now. References Go AS, Mozaffarian D, Roger VL, et al. Circulation. 2014;129(3):e28-e292.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Stop and Think

JUNE 27, 2022

Worse, patients in the MRI-guided ablation group had more major complications (9 vs 0), including 6 strokes vs none in the standard arm. The MRI-guided approach did not lead to a significantly reduced rate of AF. The theory of CardioMEMS is having wirelessly transmitted data on heart function has to be better than such mundane observations.

Outcomes 52

Outcomes Stroke Hospitals Wellness 52

Northwestern EM Blog

MAY 16, 2022

This is a great summary of the landmark randomized trial published in NEJM in 2014 assessing CT vs two types of US for patients with suspected renal colic in the ED setting. He endorses nausea without vomiting and denies fever. ACR Appropriateness Criteria® acute onset flank pain–suspicion of stone disease. Smith-Bindman, R., Bailitz, J.,

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Taming the SRU

AUGUST 30, 2023

According to a 2014 review in the Journal of Rheumatology, PCT may be useful to determine the presence of bacterial infection in patients with rheumatologic disease because it is highly specific for bacterial inflammation, although it lacks sensitivity and should not be used to rule-out bacterial infection. Epub 2014 Dec 3.

Infectious Diseases 89

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

PulmCCM

SEPTEMBER 13, 2021

This is analogous to a left ventricle with constant stroke volume and heart rate, respectively. Pulmonary circulation 2014, 4(2):211-219. However, the following model should dispel some of these half-truths. A Thought Experiment Consider a mechanical piston pump generating a constant pulsatile volume at a constant frequency.

Burns 40

Burns Stroke Ultrasounds Wellness 40

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. 2014; 14(1): 23-227. 2014; 5(4)L631-634. 2014; 12:15. However, the presence of PFO alone does not connote higher risk.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

MAY 16, 2023

Like they would for any other acute arterial occlusion syndrome (such as suspicion of acute large vessel stroke), they take the patient across the hall and perform an immediate CT (coronary) angiogram, showing patent coronaries. Imagine: the providers in the case above are not sufficiently sure that the patient above doesn't have OMI.

EKG/ECG 52

EKG/ECG Stroke Documentation/Coding Outcomes 52

Dr. Smith's ECG Blog

JULY 3, 2018

Free wall rupture, VSD, Dresslers Syndrome, chronic CHF, anatomic LV aneurysm, LV thrombus, stroke, etc). The full thickness infarction with LV aneurysm morphology places him at a higher risk for short and long term complications (e.g., Teaching points: 1.

EKG/ECG 52

EKG/ECG Documentation/Coding Administration Outcomes 52

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. 2014; 14:83. Don't go looking, if you won't do anything with the test. Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. Mayo Clin Proc.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

MARCH 6, 2019

The patients who received emergent PCI had significantly smaller median left ventricular infarct size (8% vs. 13%, p=0.001) measured by single-photon emission computed tomography study, as well as non-significant but underpowered decrease in the composite of death, recurrent MI, or stroke at 30 days (4.4% vs. 6.6%, p=0.37). Meisel et al.

EKG/ECG 52

EKG/ECG Outcomes Hospitals Wellness 52

PulmCCM

SEPTEMBER 23, 2021

The slope of Ea is measured as the end-systolic pressure [Pes] relative to the stroke volume [SV]. Pes is end-systolic pressure, Ees is end-systolic elastance, ESV is end-systolic volume, SV is stroke volume, EDV is end-diastolic volume, EDPVR is end-diastolic pressure-volume relationship. Critical Care 2014, 18(2):R80.

Stroke 40

Stroke Sepsis Shock Ultrasounds 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. A special note on codeine : Tylenol with codeine (“T3”) has never been a very effective pain medication, as up to 10% of patients lack enzymatic activity to metabolize it into morphine, its active form ( Crews 2014 ). 2014 Sep 6;12:39.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 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 105

Stroke Radiology Radiology Emergency Department 105

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. doi:10.1136/heartjnl-2014-306362 LeWinter MM. Curr Opin Support Palliat Care. 12 2019;13(4):402-407. N Engl J Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

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

EB Medicine

DECEMBER 1, 2018

Nachi: In another 2014 study by Muthuri et al., J: Also, for our NP and PA listeners, we have a special offer this month: You can get a full year of access to Emergency Medicine Practice for just $199--including lots of pharmacology, stroke, and trauma CME--and so much more! To get this special deal, go to www.ebmedicine.net/APP.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

PulmCCM

NOVEMBER 20, 2024

Patients with acute brain injuries due to strokes or trauma were generally excluded from trials testing low tidal volume ventilation, because of potential harms from elevated blood carbon dioxide levels or impairment of cerebral blood flow by high positive end-expiratory pressure (PEEP). 4 to 6 ml/kg) for patients with ARDS.

Stroke 98

Stroke Outcomes 98

PEMBlog

MAY 9, 2024

Nat Genet 2014; 46:1274. 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%. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

Seizures 59

Seizures Pediatrics Wellness Emergency Department 59

Advanced Emergency Nursing from AENJ

FEBRUARY 27, 2015

Woodrow Wilson Wilson suffered several strokes, and was isolated in the White House by his second wife, Edith, who allowed only herself and his physician to see him. He survived only four months into his fourth term, dying of a massive hemorrhagic stroke in Warm Springs, Georgia, where he would vacation and do physical therapy.

Stroke 40

Stroke COPD Emergency Nursing Sepsis 40

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. International journal of dermatology 53,7 (2014): 812-9. doi:10.1111/j.1755-5949.2010.00183.x

EMS 115

EMS Infectious Diseases CDC Research 115

EMDocs

JANUARY 6, 2025

These patients suffer from untreated physical injuries, including gunshot wounds, shrapnel, accidents, envenomations, sequelae of physical or sexual assault, and heat exhaustion/heat stroke. 8,88 Careful inquiry and a head-to-toe evaluation are necessary to exclude traumatic injuries. Qual Health Res. 2022;32(1):48-63.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75