ALiEM

JANUARY 29, 2024

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. Stroke workup for CRAO is necessary, and don’t forget about secondary prevention/risk stratification which must be part of the management. RBSS may predict poor response to systemic thrombolysis. PMID: 23023446.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

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 largest analysis of 736 critically ill patients found a mean difference of 1 mmHg which was not statistically significant, however, there was only one measurement recorded per patient.(2)

Sepsis 94

Sepsis Research Stroke Academics 94

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

PEMBlog

MARCH 19, 2024

But there are some challenges when it comes to the utilization of FOAM: – Decentralization of FOAM resources – Concerns about the quality of information being presented The Solution: The Systematic Online Academic Resource, or SOAR, review was created in an effort to address some of these limitations.

Infectious Diseases 52

Infectious Diseases Pediatrics Stroke Academics 52

EMDocs

OCTOBER 30, 2023

Relative proportions of reported diagnostic indications versus clinical outcomes in a retrospective analysis of all CT imaging in 3 EDs over 1 year at an academic center. A 12% reduction in CECTs performed was recorded after EHR interventions in a large health system encompassing 12 hospitals including academic and community medical centers.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

PulmCCM

JANUARY 6, 2025

Rather, CMS should seek counsel from leaders in systems-based processes of care, teamed with frontline emergency physicians and intensivists from academic centers and the community, who could call for briefing and expertise from other sources as appropriate.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

In uncomplicated patients with symptoms less than 48 hours and no stroke or TIA in the past six months, the 2018 Canadian Cardiovascular Society (CCS) guidelines permit rate or rhythm control (2).

Emergency Department 52

Emergency Department Stroke Academics Shock 52

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

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

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. However, peripherally dosed push dose pressors, (PDPs), are beginning to be administered more frequently for management of acute hypotension.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

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. A disease that was previously defined by symptomatic hypercalcemia became one of an asymptomatic lab abnormality.

Research 86

Research Outcomes Stroke Academics 86

Stop and Think

OCTOBER 2, 2024

It is actually simple: you use an online calculator to get your 10-year risk of a heart attack or stroke. Academic Publishing I am now up to a modest 76 peer-reviewed co-authored papers. Statin Use and the New Risk Calculator People overthink statin drugs. If the absolute risk reduction is to your liking, you take a daily pill.

Stroke 45

Stroke Academics Shock Ultrasounds 45

ACEP Now

JULY 6, 2023

5 Patients with acute ischemic strokes, STEMIs, and trauma, as well as many other diagnoses, have their workup largely completed, and even sometimes definitive therapy executed, before they leave the emergency department, rather than requiring inpatient units.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Dr. Smith's ECG Blog

JANUARY 22, 2020

It is common for physicians to ignore the atrium in this situation and forget the stroke risk. In the interest of academic discussion Ill present a nother p erspective on selected aspects this case.

EKG/ECG 52

EKG/ECG Stroke Academics Hospitals 52

Dr. Smith's ECG Blog

JANUARY 5, 2020

speci fi city of the General Electric (GE) algorithm for AF, but they excluded cases with ventricular paced rhythm (VPR), in which the underlying atrial rhythm was frequently AF;we did not exclude VPR, as accurate identi fi cation of AF in VPR is important for determination of stroke risk [ 22 ]. Poon et al. sensitivity and 98.9%

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 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. A disease that was previously defined by symptomatic hypercalcemia became one of an asymptomatic lab abnormality.

Research 40

Research Outcomes Stroke Academics 40

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

Pediatric EM Morsels

JULY 21, 2023

Academic emergency medicine 12.9 Acad Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. Performance of the Pediatric Glasgow Coma Scale in Children with Blunt Head Trauma.” 2005): 814–819. Chung CY, Chen CL, Cheng PT, See LC, Tang SF, Wong AM. 2008 Apr;39(4):1347-8. 107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

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. Limited to academic hospitals in one country, which may call generalizability into question. Post-stroke infection: a systematic review and meta-analysis. 4, 8 Paper: Dahyot-Fizelier, C., Vermeij, J.

CDC 119

CDC Radiology Radiology Head Injuries 119

ACEP Now

JANUARY 5, 2025

One of the paradoxical oddities of treatment for acute stroke is the reversal of anticoagulation to enable treatment with thrombolysis. Thrombolysis after dabigatran reversal for acute ischemic stroke: a national registry-based study and meta-analysis. Theodorou A, Melanis K, Bakola E, et al. 2024;103(7):e209862.

Sepsis 40

Sepsis Research Airway Management Stroke 40

RebelEM

SEPTEMBER 14, 2023

bleeding, stroke, limb ischemia, and hemolysis). Many centers have attempted ECLS to achieve hemodynamic stabilization in this group of patients. The benefits of this strategy may be outweighed by the risk of the device-related complications (i.e. The evidence for this practice has been sparse until now. Zeymer HT et al. Control: 53.4%

Shock 136

Shock Outcomes Resuscitation Stroke 136

Sensible Medicine

JULY 5, 2023

” “… but you could have a stroke or heart failure if you don’t get to the right place, so let’s get an EKG to confirm.” It wasn’t too long into the visit that I realized she had an irregular pulse and diagnosed her with atrial fibrillation.

EKG/ECG 97

EKG/ECG Stroke Academics 97

EM Literature of Note

JULY 4, 2022

This article pertains to the practice of telestroke administration of thrombolysis for acute ischemic stroke. In major hospital centers, there may be in-house neurology hospitalists or stroke and vascular specialists, and the expertise for management of stroke is readily at the bedside. of their series are stroke mimics.

Stroke 40

Stroke Academics Hospitals Administration 40

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. Reconfiguring emergency and acute services: time to pause and reflect. BMJ Qual Saf. BMJ Qual Saf. Her main job is working for a think tank.

Stroke 57

Stroke Emergency Department COPD Academics 57

Sensible Medicine

SEPTEMBER 23, 2024

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. As Emerson said in his 1837 American Scholar lecture: academics should think clearly not influenced by tradition or historic views. The six-year trial was not stopped.

Stroke 109

Stroke Academics Outcomes Shock 109

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

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

Don't Forget the Bubbles

JUNE 30, 2023

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. But remember – although the academic debate is great fun, don’t let it delay neuro-protective measures while debating the evidence! in the TXA group vs 53.7% in the placebo group). This study moves trauma care beyond just ‘survival’.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

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. Mortality and Complication Rates in Adult Trauma Patients Receiving Tranexamic Acid: A Single-center Experience in the Post–CRASH-2 Era. 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 Blood Transfusions Hospice Anaphylaxis 52

ACEP Now

SEPTEMBER 13, 2023

Dr. Prescott, currently retired, was Chief Academic Officer of the Association of American Medical Colleges from 2008-2021 where he says he worked with “every single school of medicine in the U.S.,” National Academics. There was no center at the NIH that looks at emergency care as a specialty.” It’s time for another push.”

EMS 45

EMS Research Academics Military 45

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

MARCH 31, 2023

Charon, Academic Med 2012) embracing fear in emergency medicine WITH dr. arlene chung What is fear? Narratives trigger changes of many kinds in both the teller and the listener, yielding meanings that are reciprocally produced by each teller-listener dyad.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

“Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. The cremasteric reflex The cremasteric reflex is a superficial reflex in males, triggered by lightly stroking the inner part of the thigh. Archives of Academic Emergency Medicine , 10 (1). Montazer, S.H., Hosseininejad, S.M.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Dr. Smith's ECG Blog

APRIL 8, 2015

Academic Emergency Medicine., 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!)

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. 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

ALiEM

NOVEMBER 18, 2024

He denied fevers, chills, nausea, vomiting, ear pain, tinnitus, hearing changes, blurry vision, photophobia, history of malignancy or HIV, history of stroke. He also endorsed left-sided facial weakness and diplopia for the last eight days. Additional Images Physical Exam Vitals : Temp 36.8°C; Munawar K, Nayak G, Fatterpekar GM, et al.

Burns 70

Burns Stroke Academics Emergency Department 70