Emergency Live

JANUARY 23, 2024

A Guide to Stroke Symptoms and Actions to Take Recognizing Stroke Signs: Symptoms Not to Ignore A stroke, or cerebrovascular accident, is a serious medical condition that occurs when the blood flow to a part of the brain is interrupted or reduced, depriving the brain tissues of oxygen and nutrients.

Stroke 90

Stroke 90

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

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 120

Stroke Outcomes Wellness 120

EM Ottawa

MAY 6, 2024

Editorial: Expanding Treatment for Acute Ischemic Stroke beyond Revascularization.

Stroke 62

Stroke Outcomes 62

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 104

Stroke Emergency Department 104

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

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

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 70

Stroke EMS Pediatrics EKG/ECG 70

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

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

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

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

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

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

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 74

Stroke Administration Outcomes Documentation/Coding 74

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

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 65

Stroke Outcomes Operations Hospitals 65

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 69

Stroke Outcomes Head Injuries Psychiatric 69

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 78

Stroke EMS Pediatrics 78

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

Sensible Medicine

FEBRUARY 12, 2024

Neurologist Hooman Kamel from the Weil Cornell Medical Center in NY had an idea about atrial fibrillation and stroke. Stroke came when these clots moved northward to the brain. One of the big issues with this theory was that studies had failed to show a strong relationship in time between the stroke and the irregular rhythm.

Wellness 128

Wellness Stroke EKG/ECG Academics 128

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

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 68

Stroke EKG/ECG Wellness 68

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

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

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

EMDocs

MARCH 19, 2024

Thromboembolism can lead to stroke (and this is a more common cause of stroke in the setting of sCAD than hypoperfusion). Epidemiology Common cause of strokes in young people; sCAD accounts for 15-24% of strokes in patients < 45 years. Rare cause of stroke overall – incidence is 1.72

Stroke 89

Stroke EMS Administration Ultrasounds 89

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

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 Outcomes EMS 52

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.

Stroke 52

Stroke EMS 52

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

Sensible Medicine

MAY 6, 2024

A treatment to reduce stroke is tested in a clinical trial. of patients had a stroke vs 2.9% In the PROTECTED TAVR trial, the confidence intervals went from -1.7% (a lower stroke rate) to 0.5% (a higher rate of stroke). In the treatment group, 2.3% in the control arm. difference is signal or noise. Emphasis mine.)

Stroke 88

Stroke Shock Outcomes 88