RebelEM

SEPTEMBER 14, 2023

bleeding, stroke, limb ischemia, and hemolysis). Many centers have attempted ECLS to achieve hemodynamic stabilization in this group of patients. The benefits of this strategy may be outweighed by the risk of the device-related complications (i.e. The evidence for this practice has been sparse until now. Zeymer HT et al. Control: 53.4%

Shock 119

Shock Outcomes Resuscitation Stroke 119

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation Research EMS 52

ACEP Now

AUGUST 25, 2023

The differences observed in this study make it uncertain if these findings can be generalized outside of these academic settings. Am J Hematol. Am J Hematol. Further, when the analysis includes only sites that administer IN fentanyl, the association is even stronger.

Administration 97

Administration Pediatrics Outcomes Emergency Department 97

Sensible Medicine

JULY 5, 2023

” “… but you could have a stroke or heart failure if you don’t get to the right place, so let’s get an EKG to confirm.” It wasn’t too long into the visit that I realized she had an irregular pulse and diagnosed her with atrial fibrillation.

EKG/ECG 86

EKG/ECG Stroke Academics 86

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Date: January 29th, 2020 Reference: Perry et al.

Emergency Department 52

Emergency Department Stroke EMS Academics 52

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

In uncomplicated patients with symptoms less than 48 hours and no stroke or TIA in the past six months, the 2018 Canadian Cardiovascular Society (CCS) guidelines permit rate or rhythm control (2).

Emergency Department 52

Emergency Department Stroke Academics Shock 52

Dr. Smith's ECG Blog

MAY 30, 2023

We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. What to do? RVMI explains part of the shock.

Shock 75

Shock EKG/ECG Academics Stroke 75

EM Literature of Note

JULY 4, 2022

This article pertains to the practice of telestroke administration of thrombolysis for acute ischemic stroke. In major hospital centers, there may be in-house neurology hospitalists or stroke and vascular specialists, and the expertise for management of stroke is readily at the bedside. of their series are stroke mimics.

Stroke 40

Stroke Academics Hospitals Administration 40

ACEP Now

JULY 6, 2023

5 Patients with acute ischemic strokes, STEMIs, and trauma, as well as many other diagnoses, have their workup largely completed, and even sometimes definitive therapy executed, before they leave the emergency department, rather than requiring inpatient units.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Don't Forget the Bubbles

JUNE 30, 2023

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. But remember – although the academic debate is great fun, don’t let it delay neuro-protective measures while debating the evidence! in the TXA group vs 53.7% in the placebo group). This study moves trauma care beyond just ‘survival’.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

ALiEM

JANUARY 29, 2024

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. Stroke workup for CRAO is necessary, and don’t forget about secondary prevention/risk stratification which must be part of the management. RBSS may predict poor response to systemic thrombolysis. PMID: 23023446.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

Taming the SRU

MARCH 31, 2023

Charon, Academic Med 2012) embracing fear in emergency medicine WITH dr. arlene chung What is fear? Narratives trigger changes of many kinds in both the teller and the listener, yielding meanings that are reciprocally produced by each teller-listener dyad.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Taming the SRU

MAY 3, 2023

Ultimately, on the cusp of deterioration, the patient was deemed most appropriate for transfer to a medical intensive care unit (MICU) at a large academic hospital via helicopter emergency medical services (HEMS). A follow-up chest x-ray at that time revealed pneumomediastinum, and she was started on broad-spectrum antibiotics.

Wellness 52

Wellness Hospitals Shock Outcomes 52

PulmCCM

MAY 8, 2023

Read in JAMA Endovascular thrombectomy for large ischemic stroke came to prominence based on limited data showing its efficacy in patients with smaller strokes; large strokes were excluded. This was a noninferiority trial; remifentanil fell below the prespecified threshold for inferiority, though with a wide confidence interval.

Stroke 52

Stroke Blood Transfusions Hospice Anaphylaxis 52

Taming the SRU

APRIL 17, 2024

3) Methods This study was a retrospective observational study at a single academic tertiary care facility in their medical intensive care unit (MICU). The largest analysis of 736 critically ill patients found a mean difference of 1 mmHg which was not statistically significant, however, there was only one measurement recorded per patient.(2)

Sepsis 82

Sepsis Research Outcomes Stroke 82

Taming the SRU

FEBRUARY 24, 2024

ENRICH Trial - the leadership journey - EMS grand rounds - r4 capstone - r1 clinical knowledge - pediatric lecture ENRICH Trial WITH visiting professor Dr. david wright ICH makes up only 10-15% of all strokes yet has a higher mortality than ischemic strokes and SAH Current 2022 AHA/ASA guidelines for spontaneous ICH (prior to ENRICH Trial) minimally-invasive (..)

Leadership 82

Leadership EMS Pediatrics Stroke 82

Pediatric EM Morsels

JULY 21, 2023

Academic emergency medicine 12.9 Acad Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. Performance of the Pediatric Glasgow Coma Scale in Children with Blunt Head Trauma.” 2005): 814–819. Chung CY, Chen CL, Cheng PT, See LC, Tang SF, Wong AM. 2008 Apr;39(4):1347-8. 107.498345.

Head Injuries 230

Head Injuries Pediatrics Outcomes Shock 230

RebelEM

FEBRUARY 29, 2024

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Limited to academic hospitals in one country, which may call generalizability into question. Post-stroke infection: a systematic review and meta-analysis. 4, 8 Paper: Dahyot-Fizelier, C., Vermeij, J.

CDC 94

CDC Outcomes Radiology Radiology 94

ACEP Now

SEPTEMBER 13, 2023

Dr. Prescott, currently retired, was Chief Academic Officer of the Association of American Medical Colleges from 2008-2021 where he says he worked with “every single school of medicine in the U.S.,” National Academics. There was no center at the NIH that looks at emergency care as a specialty.” It’s time for another push.”

Research 45

Research EMS Academics Military 45

EMDocs

OCTOBER 30, 2023

Relative proportions of reported diagnostic indications versus clinical outcomes in a retrospective analysis of all CT imaging in 3 EDs over 1 year at an academic center. A 12% reduction in CECTs performed was recorded after EHR interventions in a large health system encompassing 12 hospitals including academic and community medical centers.

Radiology 72

Radiology Radiology Emergency Department Hospitals 72

The Skeptics' Guide to EM

MAY 30, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Mortality and Complication Rates in Adult Trauma Patients Receiving Tranexamic Acid: A Single-center Experience in the Post–CRASH-2 Era. He is hypotensive and tachycardic.

Head Injuries 52

Head Injuries Academics Outcomes EMS 52

Sensible Medicine

OCTOBER 4, 2023

More recently, atrial fibrillation has gone from being a disease defined by a symptomatic arrhythmia (or an asymptomatic one diagnosed after a stroke) to one diagnosed when an asymptomatic person is alerted by his watch. A disease that was previously defined by symptomatic hypercalcemia became one of an asymptomatic lab abnormality.

Research 73

Research Outcomes Stroke Academics 73

RebelEM

JUNE 8, 2023

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. However, peripherally dosed push dose pressors, (PDPs), are beginning to be administered more frequently for management of acute hypotension.

Administration 90

Administration Emergency Department Outcomes Documentation/Coding 90

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. Stroke Authors’ Recommendation: CTA head/neck should be acquired in patients with stroke symptoms presenting within 24 hours of symptom onset.

Stroke 84

Stroke Radiology Radiology Emergency Department 84

Sensible Medicine

OCTOBER 4, 2023

More recently, atrial fibrillation has gone from being a disease defined by a symptomatic arrhythmia (or an asymptomatic one diagnosed after a stroke) to one diagnosed when an asymptomatic person is alerted by his watch. A disease that was previously defined by symptomatic hypercalcemia became one of an asymptomatic lab abnormality.

Research 40

Research Outcomes Stroke Academics 40

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. They recommend synovial joint aspiration and analysis for bacteria (and leukocytes) to diagnose SANJO [28].

Infectious Diseases 78

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 78

Don't Forget the Bubbles

FEBRUARY 7, 2024

“Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. The cremasteric reflex The cremasteric reflex is a superficial reflex in males, triggered by lightly stroking the inner part of the thigh. Archives of Academic Emergency Medicine , 10 (1). Montazer, S.H., Hosseininejad, S.M.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Dr. Smith's ECG Blog

APRIL 8, 2015

Academic Emergency Medicine., to 1.45) for fatal or nonfatal stroke. Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3). g/dL —Hypotension (obviously!)

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52