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 85

Stroke Outcomes Administration Documentation/Coding 85

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 74

Stroke Outcomes Hospitals Operations 74

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

EMDocs

JULY 20, 2023

Pre-stroke disability had to be insignificant measured by mRS (modified Rankin Scale) of 0 or 1. Presentation consistent with diagnosis of an acute ischemic stroke, with the patient meeting criteria of: Failing IV t-PA therapy; OR Patient is contraindicated for IV t-PA administration. Life expectancy had to be 6 months or greater.

Stroke 80

Stroke Outcomes Head Injuries Psychiatric 80

Board Bombs

APRIL 2, 2023

What if we told you there was a type of stroke that affected young people, caused more seizures than "typical arterial strokes", and the typical ED imaging does not diagnose it. Cerebral Venous Thrombosis: Sneaky Stroke. Cerebral Venous Thrombosis: Sneaky Stroke. Scared yet? You should be. Episode 171. Scared yet?

Stroke 52

Stroke Seizures 52

Pediatric Education

APRIL 30, 2023

She had a history of neonatal stroke for which she had received physical and occupational therapy. The mother and medical records confirmed that a cause had not been determined but the child had a neonatal arterial ischemic stroke. The mother had been evaluated for hypercoagulability which was negative.

Stroke 52

Stroke Seizures Pediatrics Hyperthermia / Hypothermia 52

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 82

Stroke EMS Pediatrics 82

Dr. Smith's ECG Blog

NOVEMBER 11, 2023

A 90-something year old woman presented with an acute mild stroke. Additional Thoughts on the Rhythm in ECG #1: As per Dr. Smith — It turned out that today's patient was 90 years old, and was being admitted for a stroke and vague chest symptoms at the time ECG #1 was obtained. This was shown to me in real time.

EKG/ECG 68

EKG/ECG Stroke Wellness 68

The Skeptics' Guide to EM

AUGUST 20, 2022

Fragility Index Meta-Analysis of Randomized Controlled Trials Shows Highly Robust Evidential Strength for Benefit of The post SGEM Xtra: Are tPA Stroke Trials Really Fragile? I knew about Jeff from his multiple publications in the stroke literature. first appeared on The Skeptics Guide to Emergency Medicine. This is an SGEM Xtra.

Stroke 52

Stroke EMS Best Practices Research 52

Ultrasound Gel

NOVEMBER 23, 2020

This article presents a novel strategy for searching for embolic etiologies in the acute phase of ischemic strokes (which means even climbing into CT with a handheld device!). Well - that very well may be the case, but hear me out- this is a fascinating idea. you may rightfully ask. That is a really great question, and I'm glad you asked.

Stroke 52

Stroke Wellness 52

EM Literatue of Note

SEPTEMBER 12, 2021

A couple months back, this little report – MaRISS – was published with minimal fanfare in Stroke. To be included in MaRISS, patients with mild stroke were approached after initial treatment, within 24 hours of hospital admission. How many patients with mild stroke were admitted to participating hospitals during the study period?

Stroke 40

Stroke Outcomes Hospitals 40

University of Maryland CC Project

MARCH 7, 2022

Edward Hebert School of Medicine at the Uniformed Services University of the Health Sciences presents on Environmental Injuries including burns, electrical, altitude and heat stroke. Dr. Kevin Chung, Professor and Chair of the Department of Medicine, and professor of Surgery, at the F.

Stroke 40

Stroke Burns Airway Management Resuscitation 40

The Skeptics' Guide to EM

MAY 15, 2021

Daniel Schwerin is employed with Prisma Health-Upstate as a clinical assistant professor, emergency medicine GME director for emergency medical services and medical director for several local EMS agencies and has lectured on prehospital stroke management. Background: We have discussed stroke so many times on the SGEM.

Stroke 52

Stroke EMS Outcomes 52

EM Literatue 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 Hospitals Academics Administration 40

Emergency Medicine Cases

SEPTEMBER 21, 2021

The post EM Quick Hits 32 Checkpoint Inhibitors, Adult Epiglotitits, HSP, Heat Stroke, Bell’s Palsy and Leukemia appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS Pediatrics Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 24, 2022

Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. He is Head of the Centre […] The post SGEM#377: You Don’t Have to “AcT” that Way – TNK for Acute Ischemic Stroke? Reference: Menon et al.

Stroke 40

Stroke Hospitals Research 40

JournalFeed

NOVEMBER 26, 2022

Wake Up Strokes Spoon Feed In patients presenting with ‘wake-up’ strokes, endovascular therapy improves functional outcomes, while intravenous alteplase may also provide a small beneficial impact.

CPR 40

CPR Stroke Outcomes 40

Emergency Medicine Cases

JULY 5, 2022

The post Ep 171 Posterior Stroke, EP Lead, HEAR Score, Ketamine for Suicidal Ideation, Peer Support Workers – Highlights from Calgary EM Hodsman Lecture Day appeared first on Emergency Medicine Cases.

EMS 52

EMS Stroke 52

Board Bombs

NOVEMBER 5, 2019

Check out our interactive question bank podcast- the FIRST of its kind here: emrapidfire.supercast.tech In a world where patients get hot, its up to us to tactically place ice packs in strategic locations to stop heat stroke. Or dunk them in a bath. Want to experience the greatest in board studying? Or dunk them in a bath.

Stroke 52

Stroke 52

The Skeptics' Guide to EM

OCTOBER 5, 2019

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomized, sham-controlled, blinded, phase 3 trial. While preparing for transport you contemplate administering nitroglycerin due to the likelihood of stroke. The Lancet March 2019. The Lancet March 2019.

Stroke 52

Stroke Hospitals EMS EKG/ECG 52

EM Literatue of Note

MARCH 9, 2021

” This “current literature” of which they speak is primarily a citation from last year’s Stroke , a single-center cohort study and updated patient-level meta-analysis. Does the eye work like that? In the “cohort” portion, this site treated 16 patients with CRAO with alteplase within 4.5

Stroke 40

Stroke Outcomes Wellness 40

First 10 EM

AUGUST 28, 2023

Katie Lin is an Assistant Professor of Emergency Medicine at the University of Calgary, a Stroke Attending with the Calgary Stroke Program, and a critical care Flight Transport Physician with STARS Air Ambulance in Alberta.

Stroke 86

Stroke 86

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 87

Stroke Outcomes Wellness 87

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 110

Stroke Ultrasounds Outcomes Wellness 110

PHEM Cast

JANUARY 22, 2019

Want to know more about stroke thrombolysis? This is the paper Martin mentions. Have a listen to this episode from our friends over at The Resus Room.

Stroke 52

Stroke 52

EMDocs

OCTOBER 21, 2023

Answer : Basilar Artery Occlusion Epidemiology:  Basilar artery occlusion (BAO) is a subset of the posterior circulation strokes. Posterior circulation strokes are estimated to account for 20% of all strokes, with BAO accounting for ~1% of all strokes. Symptoms may range from days to months prior to stroke onset.

EMS 81

EMS Stroke Outcomes Hospitals 81

The Skeptics' Guide to EM

MAY 1, 2021

Review article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the […] The post SGEM Xtra: The NNT is Mellow Yellow for tPA in Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. A systematic review and meta-analysis. Emerg Med Australas 2016.

Stroke 52

Stroke Outcomes Wellness 52

The Skeptics' Guide to EM

APRIL 25, 2020

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. There is no previous history of stroke. We have covered acute ischemic stroke many times on the SGEM.

Stroke 40

Stroke Emergency Department Hospitals Outcomes 40

JournalFeed

SEPTEMBER 5, 2020

We cover a review of acute ischemic stroke, ACP/AAFP musculoskeletal pain guidelines, antibiotics for cirrhosis with upper GI bleed, early norepinephrine for septic shock, and the best way to tape an ETT so it won’t come out. It’s the JournalFeed Podcast for the week of Aug. 31 - Sept.

Stroke 52

Stroke Shock 52

JournalFeed

JANUARY 23, 2021

We cover CT vs MRI for stroke, outpatient management of PE, VISI RCT VL vs DL for infant intubation, prehospital TXA for TBI, and how not to make your NRMP rank order list. It’s the JournalFeed Podcast for the week of Jan 18-22, 2021.

Stroke 52

Stroke 52

Emergency Medicine Ireland

NOVEMBER 30, 2020

Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. I will get to TBI. I will get to TBI but they are really quite different topics.

Stroke 40

Stroke EMS Outcomes 40

JournalFeed

APRIL 25, 2020

We cover blunt cerebrovascular injury, head CT in patients on antithrombotic agents, cooling heat stroke victims, avoiding antibiotics in pediatric pneumonia, and surviving quarantine. Here is the JournalFeed Podcast for the week of April 20-24, 2020. Special thanks to Lara Fesdekjian for writing theme music!

Stroke 52

Stroke Pediatrics 52

Emergency Medicine Cases

JULY 4, 2017

In this part 2 of EM Cases Journal Jam podcast on Thrombolysis and Endovascular Therapy for Stroke Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on endovascular therapy for stroke. The post Journal Jam 10 Part 2 Endovascular Therapy for Stroke appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS Outcomes 52

Emergency Medicine Cases

JANUARY 29, 2019

In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we’ll try to simplify the confusing time-based and brain tissue-based options for stroke management. Which patients should be considered for lytic therapy? and many more.

Stroke 52

Stroke EMS 52

Emergency Medicine Cases

JULY 4, 2017

In this two part EM Cases Journal Jam podcast Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on systemic thrombolysis for ischemic stroke followed by an analysis of endovascular therapy for stroke.

Stroke 52

Stroke EMS Documentation/Coding 52

The Skeptics' Guide to EM

FEBRUARY 26, 2019

This has been through various peer reviewed publications, doing Emergency Medicine Abstracts (EMA) audio program […] The post SGEM Xtra: No Retreat, No Surrender – Thrombolysis for Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. It appears his concerns may have come true. Six trials showed no benefit.

Stroke 52

Stroke EMS Outcomes Research 52

PulmCCM

NOVEMBER 11, 2021

To focus matters, the hemodynamic variable under consideration is the stroke volume [SV]; in other words, how does a push of phenylephrine affect SV? ’ Diminished stroke volume? In the former group, stroke index [i.e., SV] increased significantly, while in the latter group, stroke index fell in response to phenylephrine.

Stroke 40

Stroke Sepsis Administration Wellness 40