The Skeptics' Guide to EM

MARCH 6, 2019

Shahriar Zehtabchi is a tenured professor and Vice Chair of Academic Affairs in the Department of Emergency Medicine at SUNY Downstate Medical Center & Kings County Hospital. Shahriar also serves […] The post SGEM Xtra: Walk of Life – Thrombolysis for Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine.

Stroke 40

Stroke Academics Hospitals Outcomes 40

Sensible Medicine

SEPTEMBER 23, 2024

They also found that the largest difference between truncated and nontruncated trials occurred when the truncated trials had fewer than 500 outcome events. The rate of the composite primary outcome of CV death, MI, unstable angina, stroke or transient attack was 4.29% with asa vs 4.48% with placebo.

Stroke 109

Stroke Academics Outcomes Shock 109

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

PulmCCM

JANUARY 6, 2025

A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection. Administratively, CMS could convert SEP-1 to a “process”-based or “intermediate outcome measure” or another type.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Taming the SRU

APRIL 17, 2024

3) Methods This study was a retrospective observational study at a single academic tertiary care facility in their medical intensive care unit (MICU). The primary outcome was defined as agreement of less than 10 % of the mean arterial pressure (MAP) between simultaneously recorded IABP and NIBP measurements.

Sepsis 94

Sepsis Research Stroke Academics 94

The Skeptics' Guide to EM

APRIL 8, 2023

2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare. The main outcome was the adjusted odds ratio for in-hospital mortality and hazard ratio for 30-day mortality with some pre-specified subgroups.

Stroke 57

Stroke Emergency Department COPD Academics 57

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

ALiEM

JANUARY 29, 2024

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. Case Question: What treatments can you perform in the ED for this diagnosis and do they improve outcomes? This has the potential to expedite consultations with specialty teams and treatment. PMID: 23023446.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

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. Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

The Skeptics' Guide to EM

MAY 30, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. The evidence for TXA providing a patient-oriented outcome (POO) has been mixed. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is hypotensive and tachycardic.

Head Injuries 52

Head Injuries Academics EMS Stroke 52

PulmCCM

MAY 8, 2023

Read in JAMA Endovascular thrombectomy for large ischemic stroke came to prominence based on limited data showing its efficacy in patients with smaller strokes; large strokes were excluded. This was a noninferiority trial; remifentanil fell below the prespecified threshold for inferiority, though with a wide confidence interval.

Stroke 52

Stroke Hospice Blood Transfusions Anaphylaxis 52

Sensible Medicine

OCTOBER 4, 2023

More recently, atrial fibrillation has gone from being a disease defined by a symptomatic arrhythmia (or an asymptomatic one diagnosed after a stroke) to one diagnosed when an asymptomatic person is alerted by his watch. are similar from an analytical – and certainly outcomes–- perspective).

Research 86

Research Outcomes Stroke Academics 86

Dr. Smith's ECG Blog

MAY 30, 2023

We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. What to do? RVMI explains part of the shock.

Shock 97

Shock EKG/ECG Academics Stroke 97

Sensible Medicine

OCTOBER 4, 2023

More recently, atrial fibrillation has gone from being a disease defined by a symptomatic arrhythmia (or an asymptomatic one diagnosed after a stroke) to one diagnosed when an asymptomatic person is alerted by his watch. are similar from an analytical – and certainly outcomes–- perspective).

Research 40

Research Outcomes Stroke Academics 40

Taming the SRU

MAY 3, 2023

Ultimately, on the cusp of deterioration, the patient was deemed most appropriate for transfer to a medical intensive care unit (MICU) at a large academic hospital via helicopter emergency medical services (HEMS). A follow-up chest x-ray at that time revealed pneumomediastinum, and she was started on broad-spectrum antibiotics.

Wellness 52

Wellness Hospitals Shock Outcomes 52

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. They recommend synovial joint aspiration and analysis for bacteria (and leukocytes) to diagnose SANJO [28].

Infectious Diseases 89

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

Don't Forget the Bubbles

FEBRUARY 7, 2024

This week, NCEPOD (National Confidential Enquiry into Patient Outcomes and Death) produced a much-anticipated report on how we manage acute testicular torsion in young people. “Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. Archives of Academic Emergency Medicine , 10 (1).

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS. Abnormal ECG – looks for cardiac syncope. Hemoglobin less than 10 (SF rule) 6. Syncope with Exertion (EGSYS) 7. S yncope while supine (EGSYS) 8.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

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. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% 8 The data in Mayer et al.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

PulmCCM

SEPTEMBER 28, 2023

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. Do inhaled steroids improve Covid pneumonia? About two thirds of patients in each arm were vaccinated.

COPD 95

COPD Stroke Academics Urgent Care 95

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

EMDocs

FEBRUARY 3, 2025

These complications affect both the central and peripheral nervous systems and encompass a wide range of conditions, including transient ischemic attacks (TIA), stroke, headaches, mood disorders, seizures, psychosis, neuropathy, and cognitive dysfunction (1,6,7). Khan A, Shamim R, Wagan AA, Khan SM, Nazeer Ahmed S, Haroon M. Egypt Rheumatol.

Stroke 71

Stroke EMS Seizures Outcomes 71