The Skeptics' Guide to EM

APRIL 13, 2024

Tenecteplase for Stroke at 4.5 He is an assistant professor in Emergency […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. Tenecteplase for Stroke at 4.5 Reference: Albers GW et al. TIMELESS Investigators. TIMELESS Investigators.

Stroke 137

Stroke Documentation/Coding Emergency Department EMS 137

The Skeptics' Guide to EM

OCTOBER 5, 2024

Headpulse measurement can reliably identify large-vessel occlusion stroke in prehospital suspected stroke patients: Results from the EPISODE-PS-COVID study. The SGEM has covered LVO strokes several times (SGEM#137, SGEM#292, SGEM#333 and SGEM#349). Date: October 2, 2024 Reference: Paxton et al. Reference: Paxton et al.

Stroke 115

Stroke EMS Outcomes Research 115

EMDocs

JUNE 3, 2023

Answer : Cerebellar Stroke Epidemiology: 1-4% of cerebrovascular accidents occur in the cerebellum. 2 In the United States, approximately 795,000 people suffer from strokes every year. 3 Cerebellar strokes are associated with high morbidity and mortality. CT head without contrast 1 reveals the following: What is the diagnosis?

Stroke 97

Stroke EMS Pediatrics EKG/ECG 97

EM Literature of Note

SEPTEMBER 11, 2023

MARISS tried to ascertain predictors of poor outcome in mild stroke, and intravenous thrombolysis was not associated with an effect on the primary outcome. Now, again, we examine thrombolysis in “mild” stroke, in this case, NIHSS ≤3 – and fail. Well, PRISMS demonstrated unfavorable results.

Stroke 114

Stroke Outcomes Wellness 114

Emergency Live

JANUARY 23, 2024

A Guide to Stroke Symptoms and Actions to Take Recognizing Stroke Signs: Symptoms Not to Ignore A stroke, or cerebrovascular accident, is a serious medical condition that occurs when the blood flow to a part of the brain is interrupted or reduced, depriving the brain tissues of oxygen and nutrients.

Stroke 98

Stroke 98

PulmCCM

SEPTEMBER 21, 2023

Blood pressure often rises during acute ischemic strokes, in what is widely held to be a natural protective mechanism: increased blood pressure pushes more blood through and around stenotic blood vessels into areas of injured, oxygen-starved brain.

Stroke 105

Stroke Outcomes 105

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

EMDocs

JUNE 8, 2023

This week we cover the EXTEND trial looking at thrombolysis up to 9 hours after stroke onset. and 9 hours of symptom onset; stroke symptoms that started during sleep were assumed to have started halfway between the actual last known well and the time of wake-up. Intervention: Alteplase 0.9 in alteplase group versus 0.9%

Stroke 98

Stroke Administration Documentation/Coding Outcomes 98

EM Ottawa

JANUARY 2, 2024

Question: Do early vs delayed blood pressure management in patients with mild-moderate acute ischemic strokes decrease death or dependency at 90 days? Methods: Randomization to early (24 hrs) vs delayed treatment (after 7 days) of blood pressure.

Stroke 98

Stroke 98

EMDocs

AUGUST 10, 2023

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 hours of stroke onset. My take: It’s entirely possible that in comprehensive stroke centers tPA may confer no added benefit to thrombectomy for anterior circulation LVOs.

Stroke 93

Stroke Outcomes Operations Hospitals 93

The Trauma Pro

AUGUST 12, 2024

A patient found at the bottom of a flight of stairs with blood in their head did not have a stroke and then fall down. Injury can and does kill people more quickly that an MI or a stroke, especially if it was never suspected. A spot in the liver after blunt trauma is not a cyst or hemangioma; it is a laceration until proven otherwise.

Stroke 203

Stroke 203

EB Medicine

JANUARY 18, 2024

In this episode, Sam Ashoo, MD, interviews Vasisht Srinivasan, MD, FACEP one of the authors of the December 2023 Emergency Medicine Practice EXTRA article, Emergency Department Management of Stroke in Pregnant and Postpartum Patients  Epidemiology Evidence Causes Risk Factors Differential Diagnosis Prehospital Care ED History and Physical Exam (..)

Stroke 85

Stroke Emergency Department 85

Sensible Medicine

MARCH 10, 2025

Better outcomes, such as fewer heart attacks or strokes, or longer life, is why we interact with healthcare. The primary endpoint of this trial was not MI, stroke, or CV death; it was total plaque volume, with further analysis for calcified and noncalcified plaque volume on a coronary CT scan done at three years.

Stroke 85

Stroke Outcomes Hospitals 85

PEMBlog

APRIL 24, 2024

Pediatric strokes are rare and challenging to diagnose. There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team. Early consultation with a pediatric hematologist and neurologist is mandatory.

Stroke 59

Stroke Pediatrics Blood Transfusions Radiology 59

EM Ottawa

MAY 6, 2024

Editorial: Expanding Treatment for Acute Ischemic Stroke beyond Revascularization.

Stroke 63

Stroke Outcomes 63

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

Sensible Medicine

JUNE 16, 2024

The other unbelievable thing about TAVR is that strokes are less common than you’d think. Early studies show that the device catches debris that would have occluded blood vessels in the brain—iow, caused stroke. lower rate of stroke in the treatment arm. The verbs squishing or smooshing come to mind.

Stroke 74

Stroke Shock Wellness Outcomes 74

ACEP Now

MAY 9, 2024

The clinical policy on the management of adult patients presenting to the emergency department (ED) with acute ischemic stroke, was approved by the ACEP Board of Directors in April 2023. Approximately 800,000 people in the United States are diagnosed with a stroke each year at an estimated cost of approximately 46 billion dollars.

Stroke 52

Stroke Wellness Emergency Department Hospitals 52

Medagadget

JULY 19, 2023

Researchers at Florida Atlantic University have developed a soft robotic glove that can assist stroke patients to relearn how to perform dexterous tasks with their hands. The glove contains soft actuators that helps patients to move their fingers as they perform tasks, and sensors that help to create tactile sensations.

Stroke 68

Stroke Research 68

Sensible Medicine

FEBRUARY 12, 2024

Neurologist Hooman Kamel from the Weil Cornell Medical Center in NY had an idea about atrial fibrillation and stroke. Stroke came when these clots moved northward to the brain. One of the big issues with this theory was that studies had failed to show a strong relationship in time between the stroke and the irregular rhythm.

Wellness 132

Wellness Stroke EKG/ECG Academics 132

EM Ottawa

MAY 20, 2024

Question and Methods: RCT at 103 sites to compare outcomes at 30 days for early versus late DOAC initiation among patients with ischemic stroke and atrial fibrillation.

Stroke 58

Stroke Outcomes 58

PulmCCM

MAY 3, 2024

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. Studies in animal models have suggested corticosteroids might reduce infarct size or extension of subsequent cerebral edema.

Stroke 52

Stroke Outcomes Hospitals 52

Board Bombs

JUNE 3, 2024

Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Cite this podcast as: Briggs, Blake.

Stroke 52

Stroke 52

Board Bombs

JUNE 3, 2024

Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Cite this podcast as: Briggs, Blake.

Stroke 52

Stroke 52

Ken Grauer, MD

JUNE 22, 2024

As another alternative consideration — Diffuse ST-T wave abnormalities ( including T wave inversion ) as are seen in ECG #1 could be the result of a non -cardiac condition — including marked metabolic and/or electrolyte disturbance, CNS catastrophe (ie, stroke, intracerebral or subarachnoid bleed, trauma, tumor ), severe anemia, "sick" patient, etc.

EKG/ECG 433

EKG/ECG Stroke Documentation/Coding Wellness 433

PulmCCM

JUNE 28, 2024

Alteplase (recombinant tissue plasminogen activator or r-tPA) has been widely used for many years as a reperfusion therapy for ischemic stroke.

Stroke 52

Stroke 52

PulmCCM

OCTOBER 23, 2024

Endovascular thrombectomy became standard care for ischemic strokes resulting from large vessel occlusion (LVO) in the anterior cerebral circulation after randomized trials published in the mid-2010s showed improved outcomes with the intervention. Multiple randomized trials have been performed testing thrombectomy for large ischemic strokes.

Stroke 52

Stroke Outcomes 52

PEMBlog

JULY 1, 2024

Heat Stroke is a serious medical diagnosis that can be differentiated from other forms of heat illness. Got to cool them down How these videos were produced This song and video were created using Artificial Intelligence programs: I began by writing custom lyrics inspired by notable genres and music artists.

Stroke 52

Stroke 52

University of Maryland Department of Emergency Med

NOVEMBER 2, 2023

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

Stroke 64

Stroke Documentation/Coding EMS 64

EM SIM Cases

NOVEMBER 20, 2023

WHY IT MATTERS Classic heat stroke is a potentially deadly diagnosis that effects some of the most vulnerable of our populations. There are some key differences between exertional and classic heat stroke management and this case gives the opportunity to practice and discuss these skills.

Stroke 52

Stroke Hyperthermia / Hypothermia EMS EKG/ECG 52

American Medical Compliance

APRIL 17, 2024

The following Effective Management of Dysphagia in Stroke Patients Training educates healthcare providers (HCP) on the structures involved in swallowing. million stroke survivors in the US. Aspiration pneumonia is the most common consequence of dysphagia following a stroke.

Stroke 52

Stroke Dehydration Outcomes 52

Emergency Live

AUGUST 9, 2024

“Heat stroke” lethal for our body […] The post Heat stroke: a serious risk for the liver appeared first on Emergency Live. Besides causing the most well-known headaches, nausea and dizziness, they can have very serious consequences, especially on the liver.

Stroke 52

Stroke Wellness 52

PulmCCM

APRIL 19, 2024

There were lingering hopes that for patients with ischemic stroke, adding parenteral anticoagulation after thrombolytic therapy might improve outcomes.

Stroke 52

Stroke Outcomes 52

PulmCCM

MAY 12, 2024

Endovascular thrombectomy became standard care for ischemic strokes resulting from large vessel occlusion (LVO) in the anterior cerebral circulation after randomized trials published in the mid-2010s showed improved outcomes with the intervention. The LASTE Trial: Thrombectomy f… Read more

Stroke 52

Stroke Outcomes 52

PulmCCM

MAY 27, 2024

Uncontrolled hypertension is a major risk factor for both ischemic and hemorrhagic strokes. Maintaining blood pressure at or near the normal range (again, over long periods) reduces the risk of stroke. Once an acute stroke is underway, however, the calculus changes.

Stroke 52

Stroke Hospitals 52

Sensible Medicine

NOVEMBER 6, 2023

Many doctors believe that closing the left atrial appendage (with a device) will help reduce stroke and bleeding. The idea behind stroke reduction is that occluding the appendage takes away a common area where clots form. I’ve already told you that peri-device leaks are associated with an increase in stroke risk.

Stroke 133

Stroke Outcomes Ultrasounds Wellness 133

Sensible Medicine

NOVEMBER 20, 2023

That means reducing events caused by clots—like stroke. The OCEANIC AF trial enrolled patients with AF who had stroke risk factors. The primary outcome was stroke or systemic embolism. Things like survival and stroke. Here’s the thing: an espresso would lead to less bleeding than any anticoagulant.

Stroke 124

Stroke Outcomes Wellness 124