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The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

RebelEM

Background : Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. mg/kg non-inferior to alteplase in the treatment of acute ischemic stroke? vs Alteplase 34.8%

Stroke 135
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Tools you should use: Pediatric NIH Stroke Scale

PEMBlog

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
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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Based on light absorption from blood flow at the sensor site (using HbA, not HbS) Underestimates alveolar hypoxemia. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. All patients with ACS should receive antibiotics, as 25% have an infection as the trigger for ACS. Everyone needs atypical coverage.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Based on light absorption from blood flow at the sensor site (using HbA, not HbS). Blood transfusion Reduces the overall proportion of HbS. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Underestimates alveolar hypoxemia. Improves oxygen carrying capacity. Reduces progression to severe disease.

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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% Majority of patients (92%) had blunt trauma. 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7%

Outcomes 104
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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

The amount of blood that comes from the heart with each contraction is the stroke volume (SV). The stroke volume is the difference between how full it is at the start and how full it is after a contraction. The next element of stroke volume is the emptying.

Shock 143
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Grand Rounds Recap 3.29.23

Taming the SRU

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%