article thumbnail

For undifferentiated strokes, should blood pressure be aggressively managed pre-hospital?

PulmCCM

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
article thumbnail

Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

Stroke 72
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Trending Sources

article thumbnail

SGEM Xtra: Here Comes the NINDS Again

The Skeptics' Guide to EM

Risk of selection bias assessment in the NINDS rt-PA stroke study. Risk of selection bias assessment in the NINDS rt-PA stroke study. While this is true, we are part of the team that diagnose and treat acute stroke patients. This committee’s findings supported the use of tPA in less than three hours ( Ingall et al 2004).

Stroke 52
article thumbnail

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

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). PMID: 21422387 Wan S et al. PMID: 15262836 Sharifi M et al. PMID: 27422214 Wang C et al.

Outcomes 121
article thumbnail

Glasgow Coma Scale in Children

Pediatric EM Morsels

Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 PubMed: 29631516] van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the Glasgow Coma Scale. 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345. 107.498345.

article thumbnail

Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases , 22 Suppl 3 , S37–S62. Tunkel, A. Hartman, B. Kaplan, S. Kaufman, B. Scheld, W. M., & Whitley, R. Practice guidelines for the management of bacterial meningitis.

article thumbnail

ICU Physiology in 1000 Words: The Geometry of Ejection Fraction

PulmCCM

The slope of Ea is measured as the end-systolic pressure [Pes] relative to the stroke volume [SV]. Pes is end-systolic pressure, Ees is end-systolic elastance, ESV is end-systolic volume, SV is stroke volume, EDV is end-diastolic volume, EDPVR is end-diastolic pressure-volume relationship. The base of right triangle 1.]

Stroke 40