EMDocs

SEPTEMBER 8, 2024

Study inclusion criteria: RCT or nonrandomized comparative observational studies Neurologic emergencies defined as: Hypertensive encephalopathy Ischemic stroke Hemorrhagic stroke Subarachnoid hemorrhage TBI Anti-hypertensive agents included nicardipine, clevidipine, labetalol, and nitroprusside. 2016 Sep 15;375(11):1033-43.

Stroke 105

Stroke Outcomes Hospitals 105

The Skeptics' Guide to EM

MAY 1, 2021

Review article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the […] The post SGEM Xtra: The NNT is Mellow Yellow for tPA in Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. Emerg Med Australas 2016. A systematic review and meta-analysis.

Stroke 52

Stroke Outcomes Wellness 52

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). Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials.

Stroke 136

Stroke Outcomes Hospitals Administration 136

The Skeptics' Guide to EM

JUNE 11, 2017

Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016. Lancet 2016. Non-contrast head CT shows a hemorrhagic stroke. Lancet 2016. Reference: Baharoglu et al.

Stroke 52

Stroke EMS Outcomes 52

The Skeptics' Guide to EM

OCTOBER 3, 2020

Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. NEJM […] The post SGEM#303: Two Can Make It – Less likely to have another stroke but more likely to have a bleed (THALES Trial) first appeared on The Skeptics Guide to Emergency Medicine. Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA.

Stroke 40

Stroke Emergency Department Research Wellness 40

PulmCCM

NOVEMBER 11, 2021

To focus matters, the hemodynamic variable under consideration is the stroke volume [SV]; in other words, how does a push of phenylephrine affect SV? ’ Diminished stroke volume? In the former group, stroke index [i.e., SV] increased significantly, while in the latter group, stroke index fell in response to phenylephrine.

Stroke 40

Stroke Sepsis Administration Wellness 40

Dr. Smith's ECG Blog

OCTOBER 12, 2024

CTA head and neck were obtained and showed no evidence of intracranial hemorrhage, large vessel occlusion stroke (what a helpful and apt name for an acute arterial occlusion paradigm, by the way.), 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. Vital signs were within normal limits on arrival to the Emergency Department.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Date: January 29th, 2020 Reference: Perry et al.

Emergency Department 52

Emergency Department Stroke EMS Academics 52

RebelEM

MARCH 8, 2023

CRAO is a stroke of the eye; patients should be considered for a complete stroke work up. Eye Emergencies, in Tintinalli J et al (eds): Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition New York City: McGraw-Hill 2016 (Ch) 241 Guluma K, Lee JE. et al, Emergency Medicine Clinical Essentials ed 2.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

Taming the SRU

FEBRUARY 24, 2024

ENRICH Trial - the leadership journey - EMS grand rounds - r4 capstone - r1 clinical knowledge - pediatric lecture ENRICH Trial WITH visiting professor Dr. david wright ICH makes up only 10-15% of all strokes yet has a higher mortality than ischemic strokes and SAH Current 2022 AHA/ASA guidelines for spontaneous ICH (prior to ENRICH Trial) minimally-invasive (..)

Leadership 94

Leadership EMS Pediatrics Stroke 94

Taming the SRU

FEBRUARY 5, 2024

C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). Glennie, L., Gaillemin, O., Wyncoll, D., Kaczmarski, E., Thwaites, G., Davies, N. C., & Solomon, T. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. Mourvillier, B.,

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

The Skeptics' Guide to EM

DECEMBER 16, 2017

NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. [display_podcast] Date: November 27th, 2017 Reference: Legriel et al.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

Taming the SRU

OCTOBER 7, 2024

The contraindications are the same as for the non-pregnant patient including: prior ICH, known brain lesion/malignancy, ischemic stroke in the past three months, suspected aortic dissection, active bleeding, and closed head trauma in the past three months. 2016 Mar-Apr;27(2):89-94. doi: 10.5830/CVJA-2016-021. Cardiovasc J Afr.

Ultrasounds 64

Ultrasounds CDC Research Stroke 64

RebelEM

JUNE 8, 2023

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. 2016; PMID: 27720568 Guest Post By: Courney Knieriem, MD PGY-1, Emergency Medicine Resident RWJBH Community Medical Center, Toms River, NJ Courtneyknieriem.md@rutgers.edu

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EB Medicine

JANUARY 10, 2020

MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death. MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death. Part 2 : Why do we care? Part 2 : Why do we care? *

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

EMDocs

OCTOBER 30, 2023

In acute ICM contrast shortages, a tier-based necessity system may preserve contrast for emergent studies such as stroke, hemodynamically unstable trauma, aortic dissection, AAA rupture, active GI bleed, PE, acute mesenteric ischemia, etc. Published online 2016. Journal of Medical Imaging and Radiation Oncology.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

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. Ther Adv Drug Saf.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

ACEP Now

NOVEMBER 7, 2023

8-12 A recent scoping review published in The American Journal of Emergency Medicine reviewed articles between 2016 and 2019, and found 18 observational studies, which failed to demonstrate sufficient evidence for widespread implementation of DSED. Heart disease and stroke statistics—2014 update: a report from the American Heart Association.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

ACEP Now

DECEMBER 11, 2023

2 describe their patient developing a stroke following PCI, in the setting of pancreatitis induced STE. Emergency Medicine Reports website.Published June 1, 2016. Missing ACS has fatal consequences, as does converting acute pancreatitis to hemorrhagic pancreatitis with thrombolytics. References Velez L, Hockstein M, Furmaga J, et al.

EKG/ECG 52

EKG/ECG Hospitals Stroke Emergency Department 52

Mind The Bleep

FEBRUARY 12, 2024

Examples of causes of each are listed below. Bilateral congenital mydriasis in a child case. Turk Pediatri Arsivi-turkish Archives of Pediatrics , [online] 51(3), pp.176–177. doi:[link] Dr Mary Lowth (2017). Pupillary Abnormalities.

Stroke 52

Stroke Pediatrics 52

Advanced Emergency Nursing from AENJ

JULY 10, 2016

The standard "QWERTY" keyboard still in use was designed to slow the typist down as a fast typist could stroke the key levers into hitting each other and jamming the typewriter.) Remember to thank her greatly in your "Acknowledgements." " It took longer than expected.

Military 40

Military Emergency Nursing Stroke 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. 2016; 203:138-140. 2016; 10(6):14-15. 2016; 17:2. However, the presence of PFO alone does not connote higher risk. Cardiol Young.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Taming the SRU

AUGUST 30, 2023

2016 Dec;115(6):317-21. 2016 Aug 23;134(8):e113. Bray C, Bell LN, Liang H, Haykal R, Kaiksow F, Mazza JJ, Yale SH. Erythrocyte Sedimentation Rate and C-reactive Protein Measurements and Their Relevance in Clinical Medicine. PMID: 29094869. Brigden ML. Clinical utility of the erythrocyte sedimentation rate. Am Fam Physician.

Infectious Diseases 89

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

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. 2016; 417: 54–56. 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. Pediatr Cardiol.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 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

EB Medicine

AUGUST 1, 2018

First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA. times higher risk of stroke or TIA. Jeff: Let’s talk about some of the clinical findings and systemic effects associated with cannabis use. Cannabis users who smoked at least once weekly had a 3.3 2015;313(24):2456-2473. Subst Abus.

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 96

Hyperthermia / Hypothermia EMS Stroke Seizures 96

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

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). European Journal of Pediatrics; 2016: 175; 1461-1462 Cox, GF. The LV dysfunction is often asymptomatic in the early stages of the disease. Journal Heart Lung Transplant.

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

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. Cooling Methods in Heat Stroke. J Emerg Med 2016. Ann Pharmacother 2016. Resuscitation 2020. Druyan A, Janovich R, Heled Y.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

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 2016 * Response from Prof. Reference: Alper et al.

Stroke 52

Stroke Research Hospitals Emergency Department 52

The Skeptics' Guide to EM

APRIL 3, 2021

mg/kg) was beneficial for unknown onset stroke above a certain core size. Stroke 2021 Case: A 74-year-old man presents to the emergency department after waking up with left sided weakness. Background: We have talked about stroke management a number of times recently including SGEM#297 on the reanalysis of ECASS-3 by Alper et al 2020.

Stroke 52

Stroke Research Outcomes Emergency Department 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 2016, 20(1):270.

Stroke 40

Stroke Sepsis Shock Ultrasounds 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Finally, much of this correlates well with The new Canadian Syncope Arrhythmia Risk Score , just published in 2016, results of which are given below in the Annotated Bibliography. to 1.45) for fatal or nonfatal stroke. to 1.51) for death from any cause, 1.27 (95 percent confidence interval, 0.99 to 3.80).

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Pediatric Emergency Playbook

JANUARY 1, 2017

NON-PHARMACOLOGIC TREATMENT The first line of treatment in all pain management is non-pharmacopeia ( Horeczko 2016 ). Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. mg/kg IV, up to 10 mg) may be substituted for ibuprofen ( Paniyot 2016 ). 2016 Feb;29 Suppl 1:S48-55. Pediatrics.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EB Medicine

FEBRUARY 1, 2019

Nachi: And patients with neurologic deficits or severe sudden-onset headaches, should be transported immediately to the nearest available stroke center. In addition, one 2016 study demonstrated a LR of 0.01 CAD accounts for 2% of all strokes and is commonly associated with trauma and connective tissue disorders.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 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