Remove Administration Remove Hyperthermia / Hypothermia Remove Stroke
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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy?

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

Excessive IV fluid administration should be avoided due to the risk of acidosis, coagulopathy and electrolyte disturbance – all of which evidence shows significantly increased mortality. In the bleeding trauma patient, fluid resuscitation aims to avoid the diamond of death (acidosis, coagulopathy, hypothermia and hypocalcaemia).

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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

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.), Vital signs were within normal limits on arrival to the Emergency Department. Blood glucose was not low at 162 mg/dL. or basilar ischemia.

EKG/ECG 117
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2021 Wrap-Up

EM Literature of Note

A Chilling Conclusion to the Hypothermia Debate? link] Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke Stopped early due poor outcomes in patients receiving alteplase prior to endovascular therapy. Stylet, No?

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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This guideline revision is particularly timely as EMS systems have shown their abilities to dramatically improve survival and neurologic outcome after cardiac arrest, STEMI, acute stroke, and other time-sensitive conditions. References Lulla A, et al. Prehospital Guidelines for the management of traumatic brain injury – 3rd edition.

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Episode 19 - Cannabinoids: Emerging Evidence in Use and Abuse

EB Medicine

Also, be aware that there are various formulations of cannabis that allow for different routes of administration. Basically, any way you can imagine, it seems like a route of administration has been explored. On the longer end, rectal cannabis administration can take up to 8 hours to reach peak plasma concentrations.

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Grand Rounds Recap 8.9.23

Taming the SRU

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2