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

RebelEM

FEBRUARY 1, 2024

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 119

Stroke Blood Transfusions Outcomes EMS 119

EMDocs

MAY 15, 2024

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.

Blood Transfusions 69

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 69

Don't Forget the Bubbles

NOVEMBER 27, 2023

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

Shock Sepsis Fluid Resuscitation Resuscitation 143

RebelEM

JUNE 19, 2023

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 99

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 99

Taming the SRU

APRIL 3, 2023

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%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

EMDocs

JULY 3, 2023

National Institutes of Health Stroke Scale (NIHSS) is 13; vital signs include pulse 86 beats/minute (bpm), blood pressure 164/94 mmHg, and saturation of 98% on room air. 14 The American Stroke Association (ASA) and American Heart Association (AHA) recommend SBP <160 mmHg until definitive management of the bleed is completed.

Seizures 83

Seizures Stroke Outcomes EMS 83