The Skeptics' Guide to EM

APRIL 13, 2024

Tenecteplase for Stroke at 4.5 He is an assistant professor in Emergency […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guide to Emergency Medicine. Tenecteplase for Stroke at 4.5 Reference: Albers GW et al. TIMELESS Investigators. TIMELESS Investigators.

Stroke 128

Stroke Documentation/Coding Emergency Department EMS 128

EM Literature of Note

SEPTEMBER 11, 2023

MARISS tried to ascertain predictors of poor outcome in mild stroke, and intravenous thrombolysis was not associated with an effect on the primary outcome. Now, again, we examine thrombolysis in “mild” stroke, in this case, NIHSS ≤3 – and fail. Well, PRISMS demonstrated unfavorable results.

Stroke 119

Stroke Outcomes Wellness 119

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

PEMBlog

JULY 1, 2024

Heat Stroke is a serious medical diagnosis that can be differentiated from other forms of heat illness. Got to cool them down How these videos were produced This song and video were created using Artificial Intelligence programs: I began by writing custom lyrics inspired by notable genres and music artists.

Stroke 52

Stroke 52

ACEP Now

MAY 9, 2024

The clinical policy on the management of adult patients presenting to the emergency department (ED) with acute ischemic stroke, was approved by the ACEP Board of Directors in April 2023. Approximately 800,000 people in the United States are diagnosed with a stroke each year at an estimated cost of approximately 46 billion dollars.

Stroke 52

Stroke Wellness Emergency Department Hospitals 52

EMDocs

JUNE 3, 2023

Answer : Cerebellar Stroke Epidemiology: 1-4% of cerebrovascular accidents occur in the cerebellum. 2 In the United States, approximately 795,000 people suffer from strokes every year. 3 Cerebellar strokes are associated with high morbidity and mortality. CT head without contrast 1 reveals the following: What is the diagnosis?

Stroke 73

Stroke EMS Pediatrics EKG/ECG 73

Board Bombs

JUNE 3, 2024

Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Now it's time to recognize the 5 D's of posterior circulations strokes and fast facts to not miss them. The Deadly D's: cerebellar strokes. Cite this podcast as: Briggs, Blake.

Stroke 52

Stroke 52

PulmCCM

SEPTEMBER 21, 2023

Blood pressure often rises during acute ischemic strokes, in what is widely held to be a natural protective mechanism: increased blood pressure pushes more blood through and around stenotic blood vessels into areas of injured, oxygen-starved brain.

Stroke 105

Stroke Outcomes 105

PulmCCM

MAY 3, 2024

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. Studies in animal models have suggested corticosteroids might reduce infarct size or extension of subsequent cerebral edema.

Stroke 52

Stroke Outcomes Hospitals 52

EB Medicine

JANUARY 18, 2024

In this episode, Sam Ashoo, MD, interviews Vasisht Srinivasan, MD, FACEP one of the authors of the December 2023 Emergency Medicine Practice EXTRA article, Emergency Department Management of Stroke in Pregnant and Postpartum Patients  Epidemiology Evidence Causes Risk Factors Differential Diagnosis Prehospital Care ED History and Physical Exam (..)

Stroke 88

Stroke Emergency Department 88

EM Ottawa

MAY 20, 2024

Question and Methods: RCT at 103 sites to compare outcomes at 30 days for early versus late DOAC initiation among patients with ischemic stroke and atrial fibrillation.

Stroke 59

Stroke Outcomes 59

EMergucate

JULY 18, 2024

Intensive Ambulance-Delivered Blood- Pressure Reduction in Hyperacute Stroke Li, Y. Anderson, C. … Continue reading →

Stroke 52

Stroke 52

Sensible Medicine

JUNE 16, 2024

The other unbelievable thing about TAVR is that strokes are less common than you’d think. Early studies show that the device catches debris that would have occluded blood vessels in the brain—iow, caused stroke. lower rate of stroke in the treatment arm. The verbs squishing or smooshing come to mind.

Stroke 73

Stroke Shock Wellness Outcomes 73

American Medical Compliance

APRIL 17, 2024

The following Effective Management of Dysphagia in Stroke Patients Training educates healthcare providers (HCP) on the structures involved in swallowing. million stroke survivors in the US. Aspiration pneumonia is the most common consequence of dysphagia following a stroke.

Stroke 52

Stroke Dehydration Outcomes 52

PulmCCM

MAY 27, 2024

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

Stroke Hospitals 52

EM Ottawa

JANUARY 2, 2024

Question: Do early vs delayed blood pressure management in patients with mild-moderate acute ischemic strokes decrease death or dependency at 90 days? Methods: Randomization to early (24 hrs) vs delayed treatment (after 7 days) of blood pressure.

Stroke 98

Stroke 98

EM SIM Cases

NOVEMBER 20, 2023

WHY IT MATTERS Classic heat stroke is a potentially deadly diagnosis that effects some of the most vulnerable of our populations. There are some key differences between exertional and classic heat stroke management and this case gives the opportunity to practice and discuss these skills.

Stroke 52

Stroke Hyperthermia / Hypothermia EMS EKG/ECG 52

EM Ottawa

MAY 6, 2024

Editorial: Expanding Treatment for Acute Ischemic Stroke beyond Revascularization.

Stroke 65

Stroke Outcomes 65

PulmCCM

MAY 12, 2024

Endovascular thrombectomy became standard care for ischemic strokes resulting from large vessel occlusion (LVO) in the anterior cerebral circulation after randomized trials published in the mid-2010s showed improved outcomes with the intervention. The LASTE Trial: Thrombectomy f… Read more

Stroke 52

Stroke Outcomes 52

PulmCCM

APRIL 19, 2024

There were lingering hopes that for patients with ischemic stroke, adding parenteral anticoagulation after thrombolytic therapy might improve outcomes.

Stroke 52

Stroke Outcomes 52

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

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

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

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 77

Stroke Administration Outcomes Documentation/Coding 77

University of Maryland Department of Emergency Med

NOVEMBER 2, 2023

With respect to stroke identification and treatment, ea. BACKGROUND: Prehospital (EMS) clinicians are positioned on the front lines of health care. Click to view the rest

Stroke 64

Stroke Documentation/Coding EMS 64

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 67

Stroke Outcomes Operations Hospitals 67

Emergency Medicine Journal

MARCH 21, 2024

Background In 2019, the emergency medical services (EMS) covering the western Norway Regional Health Authority area implemented its version of the prehospital clinical criteria G-FAST (Gaze deviation, Facial palsy, Arm weakness, Visual loss, Speech disturbance) to detect acute ischaemic stroke (AIS) with large vessel occlusion (LVO).

Stroke 52

Stroke Documentation/Coding EMS Hospitals 52

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 73

Stroke Outcomes Head Injuries Psychiatric 73

Emergency Medicine Journal

JUNE 20, 2024

Background Mechanical thrombectomy for stroke is highly effective but time-critical. Results Twenty-eight staff participated in 4 focus groups, 2 group interviews and 18 individual interviews across 4 Ambulance Trusts, 5 Hospital Trusts and 3 Integrated Stroke Delivery Networks (ISDNs).

Stroke 40

Stroke Hospitals 40

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 80

Stroke EMS Pediatrics 80

Kings County Downstate EM

FEBRUARY 27, 2024

EMS reports […] The post Its Getting Hot in Here: Exertional Heat Stroke Part 1 appeared first on County EM. The patient is an 18-year-old male who collapsed on the route of a half marathon. You reflect that this day is particularly warm and humid.

Stroke 40

Stroke EMS Hyperthermia / Hypothermia 40

Kings County Downstate EM

MARCH 13, 2024

Patients with impaired awareness, airway secretions, aspiration, worsening respiratory distress, or status epilepticus may […] The post So Take Off All Yo Clothes: Exertional Heat Stroke Part 2 appeared first on County EM.

Stroke 40

Stroke Resuscitation EMS 40

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 Best Practices Research EMS 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 Literature 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.

Burns 40

Burns Stroke Airway Management Resuscitation 40

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.

Stroke 71

Stroke EKG/ECG Wellness 71