RebelEM

JANUARY 29, 2024

JACCC Cardiovasc Interv 2015. 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). PMID: 26315743 Tapson VF et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

EMDocs

JUNE 28, 2023

” He could then have been treated for his stroke and not have to be in a nursing home for the rest of his life. a stroke or cardiac event). August 31, 2015) “Relationships between nurses and physicians matter” OJIN: The Online Journal of Issues in Nursing Vol. References : 1. Siedlecki, S., link] 2.

Documentation/Coding 94

Documentation/Coding EMS Stroke Patient Safety 94

The Skeptics' Guide to EM

NOVEMBER 6, 2021

Utility of Intravenous Alteplase Prior to Endovascular Stroke Treatment: A Systematic Review and Meta-analysis of RCTs. Utility of Intravenous Alteplase Prior to Endovascular Stroke Treatment: A Systematic Review and Meta-analysis of RCTs. He has a National Institute of Health Stroke Scale ( NIHSS ) score of 7.

Stroke 52

Stroke Outcomes 52

The Skeptics' Guide to EM

JUNE 5, 2021

Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial. Background: Management of acute ischemic stroke has been discussed on the SGEM ever since this knowledge translation project was launched in 2012.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

RebelEM

FEBRUARY 29, 2024

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Post-stroke infection: a systematic review and meta-analysis. 1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. Westendorp, W.

CDC 122

CDC Radiology Radiology Head Injuries 122

The Skeptics' Guide to EM

APRIL 6, 2019

He reports he has been taking apixaban to prevent stroke in the context of atrial fibrillation, which you easily recognize as one of the modern oral anti-Factor Xa inhibitors. This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran. Dabigatran is a direct thrombin inhibitor.

Stroke 52

Stroke Administration EMS Wellness 52

Taming the SRU

AUGUST 30, 2023

A 2015 prospective, cross-sectional study of 78 Thai patients published in the International Journal of Rheumatic Disease demonstrated a sensitivity of 59% and specificity of 84% for PCT with a cut-off of 0.5 2015 Mar;18(3):352-9. They recommended synovial fluid analysis as essential to the diagnosis [30]. Int J Rheum Dis. 2018.09.070.

Infectious Diseases 89

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

RebelEM

MARCH 8, 2023

CRAO is a stroke of the eye; patients should be considered for a complete stroke work up. Bagheri 2015 ). CRAO is a stroke of the eye; patients should be considered for a complete stroke work up. Take Home Points: Assess patients with floaters or flashers for retinal or vitreous detachment. Read more

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

The Skeptics' Guide to EM

MAY 23, 2020

Endovascular thrombectomy with or without intravenous alteplase in acute stroke. Endovascular thrombectomy with or without intravenous alteplase in acute stroke. Background: The issue of thrombolytics for stroke has been debated since at least 1995. Date: May 19th, 2020 Reference: Yang P et al.

Stroke 40

Stroke EMS Administration Wellness 40

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. Delusions of benefit in the International Stroke Trial. 2007;38:2001-2023. 2015;46:000-000.

Stroke 40

Stroke Outcomes Research Hospitals 40

PulmCCM

JANUARY 6, 2025

Their spread has coincided with the Centers for Medicare and Medicaid’s “sepsis bundle quality measure” (SEP-1) going live in 2015. there is no validated method to diagnose sepsis; i.e., that unlike in diabetes, strokes, and bypass surgery, there is no way to reliably quantify the denominator in the SEP-1 quality metric).

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

The Skeptics' Guide to EM

NOVEMBER 7, 2018

Case: Your next patient is a stroke alert for a 67-year-old male living at a nursing home presents with severe right sided upper and lower extremity weakness noticed one hour ago while eating a meal. This is Bob’s eighth visit to the SGEM. He obtains a stat head CT which shows an intracerebral hemorrhage.

Stroke 40

Stroke Outcomes 40

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. °C despite acetaminophen, etc).

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. 2015; 4, Art. 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. 2005; 29: 493–500.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Taming the SRU

FEBRUARY 5, 2024

Broadstock is a Clinical Instructor and Ultrasound Fellow in Emergency Medicine at the University of Cincinnati and an Assistant Editor of TamingtheSRU. REFERENCES 1. Zambito Marsala, S., Gioulis, M., & Pistacchi, M. Cerebrospinal fluid and lumbar puncture: the story of a necessary procedure in the history of medicine.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

RebelEM

MARCH 22, 2023

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. Lancet 2015. PMID: 2022022 Appleboam A et al.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

Mind The Bleep

OCTOBER 25, 2024

Adults: While strabismus is more common in children, it can also occur in adults due to trauma, stroke , or neurological conditions. 22 (2015) 271–278. It is estimated that 2-4% of children are affected by some form of strabismus before reaching the age of five. Procedures for the evaluation of strabismus in children. Pediatrics.

Stroke 52

Stroke Pediatrics Outcomes Wellness 52

Pediatric Emergency Playbook

MAY 1, 2016

For altered adults, use AEIOU TIPS (Alcohol-Epilepsy-Insulin-Overdose-Uremia-Trauma-Infection-Psychosis-Stroke). 2015; 57(4):659–664. 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! V – Vascular (e.g.

Seizures 40

Seizures Sepsis Stroke Pediatrics 40

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. °C despite acetaminophen, etc).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Advanced Emergency Nursing from AENJ

JULY 10, 2016

FOAMed author, Dr. Natalie May, in early 2015 used that firehose analogy to preface useful tips in controlling and managing the torrential quantity of information to inform our practice. " February 25, 2015. Why is there a firehose of information from which to drink? Why is it important to do this?

Military 40

Military Emergency Nursing Stroke Wellness 40

PulmCCM

DECEMBER 11, 2024

This is “burying the lede” The fact that we can’t define sepsis (and never could) is critical because it injects uncertainty (you can debate how much) into every published clinical study (as compared to, say, trials on ischemic stroke, myocardial infarction, or cancer).

Sepsis 45

Sepsis Shock Research Wellness 45

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. Jeff: Rivaroxaban, trade name Xarelto, the second FDA approved DOAC, is used for stroke prevention in those with nonvalvular afib and VTE treatment.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 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. 2015; 19(2):e107-e109. 2015; AID 953826. 2015; AID 905097. However, the presence of PFO alone does not connote higher risk.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

ACEP Now

APRIL 2, 2024

8,9 There is one case of a 17-year-old who died from acute cerebellar stroke after participating in the “One Chip Challenge” (eating a capsaicin infused food chip as a game) that prompted Hershey Co. March 13, 2015. Capsaicin pepper exposures send about 300-350 people to the hospital annually. to recall the product. J Emerg Med.

Burns 40

Burns Poisoning Seizures Stroke 40

EB Medicine

AUGUST 1, 2018

Jeff: A systematic review and meta-analysis from 2015 found low-quality evidence to support cannabis therapy for appetite suppression in HIV and aids patients; moderate-quality evidence for treatment of chronic pain and spasticity; and also moderate quality evidence for some chronic debilitating diseases. times higher risk of stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Mind The Bleep

FEBRUARY 7, 2024

Costello JM, 2015) [7] We can estimate tissue oxygen utilisation with Near infrared spectroscopy (NIRS) and use this to calculate an oxygen extraction ratio. If pulse pressure is < 15 this could be due to hyperinflation as pulse pressure is reflective of stroke volume and stroke volume is reduced by increasing mediastinal pressure.

Wellness 52

Wellness Sepsis Stroke Shock 52

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

Taming the SRU

MAY 3, 2023

Furthermore, these rapid changes in pulmonary vascular resistance can lead to significant reduction in RV stroke volume and subsequent RV dilation & tricuspid regurgitation (16). in 2015 included 25 studies, two of which were randomized control trials. A recent meta-analysis conducted by Fuller et al.

Wellness 52

Wellness Hospitals Shock Outcomes 52

EB Medicine

NOVEMBER 1, 2018

Thankfully, fatalities are declining, with just 565 in 2015. CNS dysfunction may be immediate or delayed and can range from strokes to spinal cord injuries. Thankfully, fatalities are declining, with just 565 in 2015. Their search yielded 477 articles, which was narrowed to 88 after initial review.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. 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. Jeff: What a team! Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 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

EMDocs

JULY 3, 2023

National Institutes of Health Stroke Scale (NIHSS) is 13; vital signs include pulse 86 beats/minute (bpm), blood pressure 164/94 mmHg, and saturation of 98% on room air. 14 The American Stroke Association (ASA) and American Heart Association (AHA) recommend SBP <160 mmHg until definitive management of the bleed is completed.

Seizures 98

Seizures Stroke Outcomes EMS 98

Taming the SRU

APRIL 26, 2023

J Intensive Care Med 2015. 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. Cooling Methods in Heat Stroke. Thyroid storm: an updated review. Douma MJ, Aves T, Allan KS, et al.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

Don't Forget the Bubbles

AUGUST 21, 2023

Stimulation of baroreceptors results in a catecholamine-mediated increase in heart rate , stroke volume, contractility, and systemic vascular resistance (SVR). The LV dysfunction is often asymptomatic in the early stages of the disease. A range of adaptive processes occurs to compensate for falling cardiac output. 34; 963 – 969. Bouziri A.,

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

Dr. Smith's ECG Blog

APRIL 8, 2015

to 1.45) for fatal or nonfatal stroke. Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3). g/dL —Hypotension (obviously!) to 3.80).

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. Intranasal (IN) medications offer the advantage of a fast onset for moderate-to-severe pain ( Graudins 2015 ), either as monotherapy or as a bridge to parenteral treatment (Table 4). 2015 Jun;33(6):791-5. 2015 Mar-Apr;32(2):120-5.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Northwestern EM Blog

JANUARY 3, 2022

Published 2015 Feb 23. Although most of these injuries would not be considered emergent, correct diagnosis and referral of these patients is important to keep them active and decrease their likelihood of suffering the heart attacks, strokes, and chronic pain we see daily. American Academy of Orthopaedic Surgeon. 2011;19(12):728-736.

Fractures 52

Fractures EMS Urgent Care Stroke 52