Pediatric EM Morsels

JULY 21, 2023

Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Glasgow Coma Scale in Children – How do you perform it correctly?

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Emergency Medicine Journal

SEPTEMBER 25, 2024

Ambulance crew’s main focus during stroke care is symptom recognition and rapid transport to specialist units to maximise access to and effectiveness of time-critical treatments. 4 In 2022, the Getting It Right First Time (GIRFT) stroke report 5 recommended an OST of less than 30 min for English ambulance services.

Stroke 52

Stroke Ambulance Services Hospitals 52

PulmCCM

MAY 3, 2024

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. Studies in animal models have suggested corticosteroids might reduce infarct size or extension of subsequent cerebral edema.

Stroke 52

Stroke Outcomes Hospitals 52

RebelEM

SEPTEMBER 7, 2023

BACKGROUND: intracerebral hemorrhage (ICH) makes up 10-15% of all strokes and significantly contributes to overall stroke-related morbidity and mortality ( Hostettler 2019 ). About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ). PMID: 35963261.

Seizures 132

Seizures Stroke Outcomes Research 132

Emergency Medicine Journal

DECEMBER 30, 2024

Background Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response (‘pre-alerts’) have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke).

Emergency Department 52

Emergency Department Stroke Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

AUGUST 20, 2022

Date: August 18th, 2022 Reference: Munn et al. Fragility Index Meta-Analysis of Randomized Controlled Trials Shows Highly Robust Evidential Strength for Benefit of The post SGEM Xtra: Are tPA Stroke Trials Really Fragile? Date: August 18th, 2022 Reference: Munn et al. first appeared on The Skeptics Guide to Emergency Medicine.

Stroke 52

Stroke Best Practices EMS Research 52

EMDocs

SEPTEMBER 2, 2023

. #1: Dual Antiplatelets or Lytics for Minor Stroke? Spoon Feed In minor acute ischemic stroke (AIS) patients presenting within 4.5 Source Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial. 2022 Aug 1;93(2):157-165. Epub 2022 Mar 28. #3:

Stroke 95

Stroke Pediatrics Outcomes 95

Medical Law

OCTOBER 5, 2021

Brain injury caused by failure to timely diagnose heart attack or stroke, excessive bleeding during a procedure, or failure to properly intubate a patient during surgery. Call us at (805) 962-2022 to schedule a free consultation. Spinal cord injuries caused by surgical mistakes or misdiagnosis. Amputation resulting from medical errors.

Stroke 72

Stroke 72

Broome Docs

DECEMBER 9, 2023

Does BP management in haemorrhagic stroke matter? 2022 Nov;63(5):645-650. Epub 2022 Oct 12. 2022 Oct 25;7(1):e000886. doi: 10.1136/tsaco-2022-000886. Does BP management in haemorrhagic stroke matter? Welcome to another episode of the Emergency Medicine Journal Club with Dr Justin Morgenstern. J Emerg Med.

Infectious Diseases 114

Infectious Diseases Emergency Department Stroke Pediatrics 114

EMDocs

JANUARY 29, 2024

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

Stroke 99

Stroke Outcomes EMS Seizures 99

EMDocs

OCTOBER 21, 2023

Answer : Basilar Artery Occlusion Epidemiology:  Basilar artery occlusion (BAO) is a subset of the posterior circulation strokes. Posterior circulation strokes are estimated to account for 20% of all strokes, with BAO accounting for ~1% of all strokes. Symptoms may range from days to months prior to stroke onset.

EMS 97

EMS Stroke Outcomes Hospitals 97

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. 2022 May 17:101161STR0000000000000407.

Stroke 104

Stroke Outcomes Hospitals 104

PulmCCM

DECEMBER 11, 2023

LOVIT-COVID and REMAP-CAP ) Twice-daily oral zinc reduced mortality, ICU admission rate, and hospital length of stay in patients with Covid-19 in Tunisia in 2022. Inhaled amikacin reduced the incidence of ventilator-associated pneumonia, but whether it improves hard clinical outcomes like mortality remains unknown.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

EMDocs

SEPTEMBER 3, 2024

Secondary: % change from baseline in anti-factor Xa activity during the first 2 hours from randomization Safety (assessed at 30 days): thrombotic events (ischemic stroke, VTE, myocardial infarction), mortality Results: 452 patients analyzed for the primary outcome. 2022 May 17:101161STR0000000000000407. doi: 10.1161/STR.0000000000000407.

Stroke 98

Stroke Outcomes Hospitals 98

EMDocs

JANUARY 11, 2025

A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. Admission is recommended for these patients for monitoring, given the high risk of progression to bowel necrosis, ulceration, perforation, and sepsis. EMRA Antibiotic Guide. Stercoral Colitis. Stercoral colitis.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Dr. Smith's ECG Blog

NOVEMBER 11, 2023

A 90-something year old woman presented with an acute mild stroke. Additional Thoughts on the Rhythm in ECG #1: As per Dr. Smith — It turned out that today's patient was 90 years old, and was being admitted for a stroke and vague chest symptoms at the time ECG #1 was obtained. This was shown to me in real time.

Stroke 70

Stroke EKG/ECG Wellness 70

The Skeptics' Guide to EM

AUGUST 10, 2024

A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. The 2022 AHA/ASA guidelines give several recommendations on blood pressure lowering and coagulopathy reversal along with an algorithm. Reversal of Warfarin: Freeman et al. Blood Pressure Lowering:

Stroke 90

Stroke Airway Management Documentation/Coding Outcomes 90

JournalFeed

NOVEMBER 26, 2022

The JournalFeed podcast for the week of Nov 21-25, 2022. Wake Up Strokes Spoon Feed In patients presenting with ‘wake-up’ strokes, endovascular therapy improves functional outcomes, while intravenous alteplase may also provide a small beneficial impact. These are summaries from just 2 of the 5 article we cover every week!

CPR 40

CPR Stroke Outcomes 40

Emergency Medicine Cases

JANUARY 2, 2023

Based on a blend of number of listens, feedback from listeners, website visits and my personal faves, here is EM Cases Top 10 of 2022. The post Top 10 of 2022 – EM Cases Podcasts & Blogs Highlights of the Year appeared first on Emergency Medicine Cases.

EMS 52

EMS Stroke Shock 52

ACEP Now

JULY 7, 2023

Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Published December 19, 2022.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

ALiEM

MARCH 22, 2024

The two main causes of internuclear ophthalmoplegia are demyelination of the medial longitudinal fasciculus (MLF) from multiple sclerosis (MS) and ischemic cranial nerve damage from stroke. Usually, MS is seen in younger patients where both eyes are affected whereas strokes occur more often in older patients and only one eye is affected.

Stroke 67

Stroke Urgent Care Head Injuries Emergency Department 67

Don't Forget the Bubbles

JUNE 30, 2023

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. Next of interest is a secondary analysis of the MATIC study – the MA ssive T ransfusion I n C hildren study, published in 2022. 2022 May;55:103-110. Epub 2022 Feb 7. 2022; 29: 862– 873. in the TXA group vs 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

The Skeptics' Guide to EM

JULY 9, 2022

Date: July 1st, 2022 Guest Skeptic: Dr. Ravi Garg is a Neurologist in the Department of Neurology, Division of Neurocritical Care at Loyola University Chicago. Risk of selection bias assessment in the NINDS rt-PA stroke study. 2022 Jun 15;22(1):172. Risk of selection bias assessment in the NINDS rt-PA stroke study.

Stroke 52

Stroke Emergency Department EMS Outcomes 52

EMDocs

SEPTEMBER 19, 2023

Also think about NCSE in patients with prior cerebral pathology (ie, ischemic stroke); a patient who was seizing, was treated, and is not coming out of their post ictal state; and in patients with unexplained altered mental status with no other cause. 2022 Nov 15;80(20):1925-1960. J Am Coll Cardiol.

Seizures 98

Seizures Documentation/Coding EKG/ECG Emergency Department 98

Don't Forget the Bubbles

FEBRUARY 5, 2025

According to the latest figures (2022), there were approximately 6,000 recorded offences where a child was a victim of violence, including physical assault, sexual abuse, and homicide. Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms. TXA in head injuries.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

Dr. Smith's ECG Blog

JANUARY 9, 2024

Slow VT below the detection rate of the ICD lead to worsening heart failure and low stroke volume. Lowering the back up rate (LRL) of the ICD/pacer allowed for an intrinsic rhythm with physiologic AV conduction and normal AV synchrony with resultant increase in stroke volume and cardiac outpt.

EKG/ECG 119

EKG/ECG Stroke Hospitals Documentation/Coding 119

Dr. Smith's ECG Blog

FEBRUARY 18, 2024

This could be easily overlooked since there is complete heart block, but recognizing the atrial arrhythmia may mean prescribing anticoagulation to prevent stroke. The October 21, 2022 post — for " artifactual VT". In this case, it is atrial fibrillation. Figure-1: I've labeled the artifact in today's initial ECG.

EKG/ECG 109

EKG/ECG Stroke 109

EMDocs

MAY 15, 2024

2022 Aug;58:235-244. Epub 2022 Jun 11. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia. References: Koehl JL, Koyfman A, Hayes BD, Long B. Am J Emerg Med. PMID: 35717760.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

The Skeptics' Guide to EM

APRIL 8, 2023

In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. The pre-specified subgroup analyses showed a decrease in in-hospital or 30-day mortality for myocardial infarction, stroke, aortic aneurysm, and major trauma but not for pneumonia, bowel perforation or hip fractures.

Stroke 57

Stroke Emergency Department COPD Academics 57

Taming the SRU

NOVEMBER 3, 2023

41, 2695–2701 (2022). Broad strokes In this prospective, non-randomized study published by Kring et al in January 2022 out of Maine Medical Center, researchers compared mean pain scores at rest and during incentive spirometry before, at 15 minutes after, and then 60 minutes after treatment with a serratus anterior plane block.

Fractures 98

Fractures Ultrasounds Research Outcomes 98

ACEP Now

OCTOBER 10, 2023

The CT scan reveals a hemorrhage in the right internal capsule, suggestive of acute hypertensive hemorrhagic stroke. 1,2 The 2022 AHA/ASA Guidelines give several recommendations on this topic. Symptoms began just prior to presentation. Her blood pressure (BP) is 195/104 mmHg. The language used in the guidelines is important.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

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. 2022 Sep 5. 2022 2022 Sep 5. 1-4 The PDPs, phenylephrine and epinephrine, result in vasoconstriction and increased cardiac contractility. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

PulmCCM

NOVEMBER 17, 2023

For any given hemodynamic state, measure or estimate the P ra and CO [or stroke volume, SV] simultaneously and repeatedly after each intervention. Ultrasound J 2022, 14(1):36. The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. What does this mean? Critical care medicine 1984, 12(2):107-112.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EMDocs

MAY 28, 2024

2022 Aug;58:235-244. Epub 2022 Jun 11. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS). Underestimates alveolar hypoxemia. References: Koehl JL, Koyfman A, Hayes BD, Long B. Am J Emerg Med. PMID: 35717760.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Medical Law

JULY 15, 2022

Strokes and traumatic brain injury (TBI) are the two leading causes of aphasia. And they often require a long period of rest and recuperation for related issues such as strokes or TBI. Contact our Santa Barbara law firm today by calling (805) 962-2022 for a FREE consultation. At NordstrandBlack PC, we’re on your side.

Stroke 52

Stroke 52

EM Literature of Note

OCTOBER 20, 2022

Don’t forget the Annals of Emergency Medicine Podcast , a lighthearted feel-good romantic comedy with Rory Spiegel, available for free on your choice of streaming platforms: Apple Podcasts Google Podcasts Soundcloud Bimonthly #FOAMed in ACEPNow : Updates from the 2022 International Stroke Conference A skeptical look at new tools for diagnosing (..)

Stroke 40

Stroke Sepsis Pediatrics Resuscitation 40

Mind The Bleep

FEBRUARY 5, 2024

In case of a new visual field defect, urgent imaging and referral to the ophthalmology team (or the stroke team in case of suspected stroke) for review should be undertaken. Causes: central retinal artery occlusion/amaurosis fugax, central retinal vein occlusion, optic atrophy, trauma to the optic nerve, or orbital pathologies (e.g.

Stroke 52

Stroke Operations 52