Emergency Medicine Cases

JUNE 6, 2023

The post EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund appeared first on Emergency Medicine Cases.

Stroke 85

Stroke EMS Pediatrics 85

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. 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.

EMS 93

EMS Stroke Outcomes Hospitals 93

RebelEM

JULY 27, 2023

Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed to clearly define a threshold for mild stroke.

Stroke 98

Stroke Outcomes EMS Hospitals 98

University of Maryland Department of Emergency Med

NOVEMBER 2, 2023

BACKGROUND: Prehospital (EMS) clinicians are positioned on the front lines of health care. With respect to stroke identification and treatment, ea. Click to view the rest

Stroke 64

Stroke Documentation/Coding EMS 64

Emergency Medicine Cases

MAY 13, 2024

Help support EM Cases by making a donation: [link] The post Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive appeared first on Emergency Medicine Cases.

Stroke 114

Stroke EMS Research 114

Emergency Medicine Cases

SEPTEMBER 21, 2021

The post EM Quick Hits 32 Checkpoint Inhibitors, Adult Epiglotitits, HSP, Heat Stroke, Bell’s Palsy and Leukemia appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS Pediatrics Resuscitation 52

EMDocs

MARCH 19, 2024

Thromboembolism can lead to stroke (and this is a more common cause of stroke in the setting of sCAD than hypoperfusion). Epidemiology Common cause of strokes in young people; sCAD accounts for 15-24% of strokes in patients < 45 years. Rare cause of stroke overall – incidence is 1.72

Stroke 105

Stroke EMS Administration Ultrasounds 105

Emergency Medicine Cases

JULY 5, 2022

The post Ep 171 Posterior Stroke, EP Lead, HEAR Score, Ketamine for Suicidal Ideation, Peer Support Workers – Highlights from Calgary EM Hodsman Lecture Day appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS 52

EM SIM Cases

NOVEMBER 20, 2023

Dr Brad Stebner is a staff Emergency physician in Kelowna, BC, Clinical Instructor at UBC and one of our editors at EM Sim Cases. WHY IT MATTERS Classic heat stroke is a potentially deadly diagnosis that effects some of the most vulnerable of our populations.

Stroke 52

Stroke Hyperthermia / Hypothermia EMS EKG/ECG 52

The Skeptics' Guide to EM

OCTOBER 5, 2019

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomized, sham-controlled, blinded, phase 3 trial. He’s been involved in EMS for over 30 years in a variety of roles and is a strong advocate for evidence-based EMS protocols. The Lancet March 2019.

Stroke 52

Stroke Hospitals EMS Administration 52

Emergency Medicine Journal

MARCH 21, 2024

Background In 2019, the emergency medical services (EMS) covering the western Norway Regional Health Authority area implemented its version of the prehospital clinical criteria G-FAST (Gaze deviation, Facial palsy, Arm weakness, Visual loss, Speech disturbance) to detect acute ischaemic stroke (AIS) with large vessel occlusion (LVO).

Stroke 52

Stroke Documentation/Coding EMS Hospitals 52

Emergency Medicine Cases

JULY 4, 2017

In this part 2 of EM Cases Journal Jam podcast on Thrombolysis and Endovascular Therapy for Stroke Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on endovascular therapy for stroke.

Stroke 52

Stroke EMS Outcomes 52

Emergency Medicine Cases

JULY 4, 2017

In this two part EM Cases Journal Jam podcast Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on systemic thrombolysis for ischemic stroke followed by an analysis of endovascular therapy for stroke.

Stroke 52

Stroke Documentation/Coding EMS 52

The Skeptics' Guide to EM

AUGUST 20, 2022

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? I knew about Jeff from his multiple publications in the stroke literature. first appeared on The Skeptics Guide to Emergency Medicine. This is an SGEM Xtra.

Stroke 52

Stroke Best Practices EMS Research 52

The Skeptics' Guide to EM

MAY 15, 2021

Daniel Schwerin is employed with Prisma Health-Upstate as a clinical assistant professor, emergency medicine GME director for emergency medical services and medical director for several local EMS agencies and has lectured on prehospital stroke management. Their local EMS service arrives quickly with a conventional ambulance.

Stroke 52

Stroke EMS Outcomes 52

Emergency Medicine Cases

JANUARY 29, 2019

In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we’ll try to simplify the confusing time-based and brain tissue-based options for stroke management. Which patients should be considered for lytic therapy? and many more.

Stroke 52

Stroke EMS 52

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 91

Stroke Outcomes EMS Seizures 91

EMDocs

FEBRUARY 28, 2024

Code Stroke is called and he is seen by a neurologist within 10 minutes. He is admitted with a diagnosis of brainstem stroke and treated by the neurologist with ASA only. The family consults an attorney who has the records reviewed by an EM expert before filing a lawsuit. Initial BP is 220/110. Labs are within normal limits.

Documentation/Coding 99

Documentation/Coding Stroke Outcomes EMS 99

The Skeptics' Guide to EM

FEBRUARY 26, 2019

This has been through various peer reviewed publications, doing Emergency Medicine Abstracts (EMA) audio program […] The post SGEM Xtra: No Retreat, No Surrender – Thrombolysis for Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. It appears his concerns may have come true. Six trials showed no benefit.

Stroke 52

Stroke EMS Research Outcomes 52

EMDocs

SEPTEMBER 6, 2023

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints.

Anaphylaxis 90

Anaphylaxis Shock Sepsis Stroke 90

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 ).

Seizures 123

Seizures Stroke Outcomes Research 123

Kings County Downstate EM

FEBRUARY 27, 2024

Author: Esteban Davila Peer Editor: Alec Feuerbach The Case You’re having a relatively quiet morning when you hear EMS bringing in a patient. EMS reports […] The post Its Getting Hot in Here: Exertional Heat Stroke Part 1 appeared first on County EM. You reflect that this day is particularly warm and humid.

Stroke 40

Stroke EMS Hyperthermia / Hypothermia 40

Emergency Medicine Cases

JUNE 26, 2023

Matt Douglas-Vail explains the need for Increased education on climate change and planetary health, Increased resource allocation in emergency departments for climate-related pathologies and increased disaster planning for climate-related emergencies on this month's Global EM blog.

EMS 69

EMS Emergency Department Stroke 69

RebelEM

SEPTEMBER 18, 2024

Skip the zones of the neck and focus on hard signs of vascular ( Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, Signs of stroke) or aerodigestive (Airway compromise, Bubbling wound, Extensive SubQ air, Stridor, Significant hemoptysis/hematemesis). Post Peer Reviewed By: Salim R.

Stroke 80

Stroke Shock EMS 80

EMDocs

JUNE 28, 2023

And listen to your EMS providers and nurses. EMS is called, and he is brought to the ED for a reported “slip and fall” with associated facial abrasions. EMS is called, and he is brought to the ED for a reported “slip and fall” with associated facial abrasions. EM requires a team! Examine the patient.

Documentation/Coding 87

Documentation/Coding EMS Stroke Patient Safety 87

RebelEM

AUGUST 22, 2024

What They Did: Retrospective review of consecutive RAO cases managed as part of a remote ophthalmology consult protocol activated on May 1, 2021, at three stroke centers across a health system. The protocol involved collaboration between the ophthalmology service, ED, and stroke service, including neurology and neuroendovascular teams.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

The Skeptics' Guide to EM

AUGUST 10, 2024

Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table. A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. Reversal of Warfarin: Freeman et al.

Stroke 86

Stroke Airway Management Documentation/Coding Outcomes 86

Kings County Downstate EM

MARCH 13, 2024

Patients with impaired awareness, airway secretions, aspiration, worsening respiratory distress, or status epilepticus may […] The post So Take Off All Yo Clothes: Exertional Heat Stroke Part 2 appeared first on County EM.

Stroke 40

Stroke Resuscitation EMS 40

Board Bombs

FEBRUARY 15, 2025

Boost your EM knowledge with high-yield, rapid pearls! In this episode, we cover life-saving tips for thyroid storm, beta-blocker overdose, heat stroke, SAH, and Ludwigs all in under 10 minutes. Perfect for EM boards or quick clinical refresher. Boost your EM knowledge with high-yield, rapid pearls! February 10th, 2025.

Stroke 52

Stroke EMS 52

The Skeptics' Guide to EM

APRIL 25, 2020

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. He has been practicing in Emergency Medicine for over 40 years and involved in EMS services for over 30 years.

Stroke 40

Stroke Emergency Department Outcomes Administration 40

The Skeptics' Guide to EM

MARCH 2, 2024

He will need to be transferred to the tertiary care center which is 35 minutes away by ground EMS if it is a dissection. Symptoms may include more severe chest pain radiating to the back, loss of consciousness, or symptoms of stroke if the blood supply to the brain is affected. You suspect an acute aortic dissection (AoD).

Emergency Department 131

Emergency Department Stroke Operations Hospitals 131

Emergency Medicine Ireland

NOVEMBER 30, 2020

Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. I will get to TBI. I will get to TBI but they are really quite different topics.

Stroke 40

Stroke Outcomes EMS 40

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. The post Glasgow Coma Scale in Children appeared first on Pediatric EM Morsels. In emergency medicine, we often use illness scripts and protocols to help drive our decision-making. Less than 8, intubate! 2008 Apr;39(4):1347-8. 107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Taming the SRU

AUGUST 7, 2023

The patient needs a transvaginal ultrasound w/ doppler with gynecology consult and possible laparotomy TVUS is not just for torsion, it can also be used for ectopic pregnancies or pregnancy of unknown location Acute Ischemic Stroke Updates WITH Drs. The expanded window of 3-4.5 hours increased the NNT for a good outcome to 20.

Stroke 93

Stroke Outcomes EKG/ECG Research 93

Taming the SRU

FEBRUARY 24, 2024

Sometimes even the smallest contributions can make the biggest difference in patient experience and overall ED quality.

Leadership 94

Leadership EMS Pediatrics Stroke 94

The Skeptics' Guide to EM

JANUARY 1, 2022

He became double board certified in Emergency Medicine (EM) and Emergency Medical Services (EMS). Prospective, multicenter, controlled trial of mobile stroke units. He became double board certified in Emergency Medicine (EM) and Emergency Medical Services (EMS). Howie also has a Master of Public Health.

Stroke 52

Stroke EMS Outcomes Administration 52

RebelEM

JANUARY 29, 2024

appeared first on REBEL EM - Emergency Medicine Blog. 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).

Stroke 133

Stroke Outcomes Hospitals Administration 133