Remove Operations Remove Stroke Remove Wellness
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52 in 52 – #40: DIRECT MT – Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke

EMDocs

Inclusion criteria: Enrolled patients over the age of 18 with acute ischemic stroke with CTA confirmed occlusion of ICA, or M1 or M2 segment of MCA Within 4.5 Inclusion criteria: Enrolled patients over the age of 18 with acute ischemic stroke with CTA confirmed occlusion of ICA, or M1 or M2 segment of MCA Within 4.5 N Engl J Med.

Stroke 86
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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days.

EMS 94
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Remote Consult Protocols for Retinal Artery Occlusion: A Visionary Approach in Emergency Care?

RebelEM

1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Moreover, there are multiple operational and patient-specific barriers rendering timely thrombolytic administration difficult. Patients whose last known well (LKW) time was within 24 hours of presentation. Medical comorbidities that precluded surgery.

Stroke 85
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Brain Safety After Pulsed Field Ablation for Atrial Fibrillation

Sensible Medicine

Europeans do PFA ablation in well under an hour. Stroke occurred in 7 patients (0.12%). Notable also that in the main paper, there was one TIA in the PFA arm and one stroke in the thermal arm but neither of these were in the MRI subgroup of the study. Americans can’t seem to replicate that.

Shock 127
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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Heart disease and stroke statistics-2022 update: A report from the American Heart Association.

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Sniffing out Sepsis - Vibes vs Scoring Systems?

Taming the SRU

Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world. They also developed a machine learning model using Least Absolute Shrinkage and Selection Operator (LASSO) using 80% of the available data.

Sepsis 89
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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

SBP < 75 mm Hg: 39% SBP 76-89 mm Hg: 33% Critical Findings: No statistically significant difference in safety outcomes (DVT, PE, MI, Stroke) TXA Placebo RR (95% CI) Primary Outcome Good Functional Outcome (6 months) 53.7% Demographics were well balanced in the two groups. Majority of patients (92%) had blunt trauma.