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 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 N Engl J Med.

Stroke 66

Stroke Outcomes Operations Hospitals 66

Ultrasound Gel

NOVEMBER 23, 2020

Well - that very well may be the case, but hear me out- this is a fascinating idea. 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!). I know your first thought - is this for real?! you may rightfully ask.

Stroke 52

Stroke Wellness 52

EMDocs

JULY 20, 2023

Patient had to be able to be randomized between 6-24 hours after last known well. Pre-stroke disability had to be insignificant measured by mRS (modified Rankin Scale) of 0 or 1. Take away: Positive trial The study used superior imaging techniques and extensive stroke care that may not be readily available at smaller facilities.

Stroke 71

Stroke Outcomes Head Injuries Psychiatric 71

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

Dr. Smith's ECG Blog

NOVEMBER 11, 2023

A 90-something year old woman presented with an acute mild stroke. Instead — there are deep anterior S waves (ie, 20-25 mm in leads V1,V2 ) — as well as a prominent initial R wave in lead V1 and surprisingly tall ( = 10 mm ) R wave already by lead V2 — suggesting at the least LVH , and possible increased septal forces.

Stroke 66

Stroke EKG/ECG Wellness 66

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. But, ultimately, a new medical intervention has to improve an important outcome as well as or better than standard care.

Stroke 106

Stroke Outcomes Wellness 106

Sensible Medicine

FEBRUARY 13, 2024

In brief, the trial compared apixaban vs aspirin in patients who had had a stroke of unknown source and evidence of atrial cardiopathy. Recurrent stroke (the primary endpoint) occurred in 40 patients in each group. Apixaban did not reduce the rate of recurrent stroke over aspirin in these patients. The hazard ratio was 1.00.

Stroke 73

Stroke Outcomes Wellness EKG/ECG 73

Sensible Medicine

MAY 13, 2024

Since readers of Sensible Medicine are well versed in the tragic story of anti-arrhythmic drugs to treat PVCs after MI or hormone replacement therapy in post-menopausal women to prevent cardiac events, I know that you know that acceptance of a therapy by the medical establishment does not equal supporting evidence. I can’t explain it.

Stroke 68

Stroke Wellness 68

Stop and Think

DECEMBER 29, 2023

For an older patient with stroke risk factors and 3 hours of AF on a cardiac device, pre-2023 thinking would have us leaning toward anticoagulation. Edoxaban reduced the primary endpoint of stroke, systemic embolism, and cardiovascular death by 19% (HR, 0.81; 95% CI, 0.60-1.08; hours) to edoxaban vs placebo. I don’t know.

Stroke 83

Stroke Research EKG/ECG Wellness 83

Sensible Medicine

AUGUST 28, 2023

I describe it here for two reasons: it is an example of well-conducted unbiased study, and it deals with an increasingly common problem of short-duration episodes of atrial fibrillation. Some background: In patients with certain risk factors, AF increases the risk of having a stroke. The incidence of stroke was 0.9%

Stroke 91

Stroke Wellness EKG/ECG Outcomes 91

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 128

Stroke Outcomes Ultrasounds Wellness 128

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. She was last seen well two hours prior. There is no previous history of stroke. Reference: Juergens et al.

Stroke 40

Stroke Emergency Department Outcomes Hospitals 40

EMDocs

JANUARY 29, 2024

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

Stroke 71

Stroke Outcomes EMS Seizures 71

The Skeptics' Guide to EM

OCTOBER 3, 2020

Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. NEJM […] The post SGEM#303: Two Can Make It – Less likely to have another stroke but more likely to have a bleed (THALES Trial) first appeared on The Skeptics Guide to Emergency Medicine. Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA.

Stroke 40

Stroke Emergency Department Research Wellness 40

Sensible Medicine

NOVEMBER 28, 2023

Being perfectly honest, not all the articles have aged well. First, it renewed my faith that occasionally well-done studies address interesting and important questions. The primary outcome was stroke or systemic embolism and the primary safety outcome was major bleeding. There are some, however, that I remain proud of.

Stroke 81

Stroke Academics Outcomes Administration 81

PulmCCM

SEPTEMBER 28, 2023

In most of these studies, diagnostic imaging was only performed on patients at higher pretest probability for PE according to Wells criteria or other risk stratification. In the new era of thrombectomy for ischemic strokes with large vessel occlusion, however, some early data suggested lower blood pressure targets might be advisable.

COPD 95

COPD Stroke Academics Hospitals 95

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

Sensible Medicine

OCTOBER 2, 2023

The authors chose to measure a primary outcome of death, myocardial infarction, stroke or repeat revascularization (either more stent procedures or surgeries). Curious for two reasons: First, instead of focusing on what happened with the primary outcome of death, MI, stroke and repeat procedures, they reported a slightly different outcome.

Stroke 102

Stroke Outcomes Wellness 102

ACEP Now

MARCH 6, 2024

What’s New in Stroke Care? The simplicity of tenecteplase administration makes its use likely the preferred agent for treating acute ischemic stroke. the “ARAMIS” trial throws up another red flag for patients suffering mild stroke. the “ARAMIS” trial throws up another red flag for patients suffering mild stroke.

Research 52

Research Airway Management Stroke Outcomes 52

ACEP Now

OCTOBER 10, 2023

The CT scan reveals a hemorrhage in the right internal capsule, suggestive of acute hypertensive hemorrhagic stroke. 2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association/American Stroke Association. Symptoms began just prior to presentation.

Outcomes 52

Outcomes Stroke Hospitals Emergency Department 52

Taming the SRU

AUGUST 7, 2023

The patient needs a transvaginal ultrasound w/ doppler with gynecology consult and possible laparotomy TVUS is not just for torsion, it can also be used for ectopic pregnancies or pregnancy of unknown location Acute Ischemic Stroke Updates WITH Drs. The expanded window of 3-4.5 hours increased the NNT for a good outcome to 20.

Stroke 84

Stroke Outcomes EKG/ECG Research 84

Ziqitza HealthCare Ltd

APRIL 29, 2024

Some common types of cardiovascular disease are coronary heart disease, stroke, hypertension, arrhythmia, aortic disease, valve disease, heart failure, and peripheral artery disease. Hypertension can cause types of cardiovascular diseas e , causing effects like heart attack and stroke. Cardiovascular diseases are common.

Stroke 52

Stroke Ambulance Services Burns EKG/ECG 52

Sensible Medicine

DECEMBER 28, 2023

The idea is to prevent stroke and reduce bleeding by plugging the appendage. But, get this: PREVAIL did not find noninferiority in its first co-primary endpoint of stroke, systemic embolism or cardiovascular death. It turns out the device performed less well during the pandemic. P-value now 0.049.

Stroke 125

Stroke Ultrasounds Outcomes Hospitals 125

Sensible Medicine

OCTOBER 2, 2023

The authors chose to measure a primary outcome of death, myocardial infarction, stroke or repeat revascularization (either more stent procedures or surgeries). Curious for two reasons: First, instead of focusing on what happened with the primary outcome of death, MI, stroke and repeat procedures, they reported a slightly different outcome.

Stroke 52

Stroke Outcomes Wellness 52

Taming the SRU

NOVEMBER 29, 2023

Posterior circulation stroke Patients with posterior strokes will likely have a low NIH. Involve the stroke team if posterior circulation stroke is suspected, as they may be a candidate for TNK, or more rarely, EVT. Ambulation is key during physical exam. Anticoagulation is not routinely recommended.

Stroke 52

Stroke EKG/ECG Shock Resuscitation 52

EM Literature of Note

SEPTEMBER 9, 2021

It has apparently become time for the mobile stroke unit to go from niche to prime-time. Previously consigned to the pages of Stroke and similar journals, the latest and most comprehensive trial now graces the pages of the New England Journal of Medicine. A flagship study for a flagship journal.

Stroke 40

Stroke Telemedicine EMS Administration 40

Sensible Medicine

NOVEMBER 13, 2023

We call the primary endpoint of SELECT—CV death, MI or stroke—a hard cardiovascular endpoint. There were other positive results as well. But this study shows that a weight lost drug (perhaps through other mechanisms as well) reduces hard cardiac outcomes. Meaning this was a secondary prevention study.) mg) vs 8.2%

Outcomes 106

Outcomes Stroke Wellness Research 106

The Skeptics' Guide to EM

APRIL 3, 2021

mg/kg) was beneficial for unknown onset stroke above a certain core size. Stroke 2021 Case: A 74-year-old man presents to the emergency department after waking up with left sided weakness. He was last seen well when going to bed at 10pm the night before. A SRMA was published by Mistry et al Stroke 2017.

Stroke 52

Stroke Research Outcomes Hospitals 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

And lastly, it’s actually quite hard to see how well the cardiovascular system is working, and this is one of its measurable features. This works well for a while, but eventually, the heart beats too fast to fill adequately. The amount of blood that comes from the heart with each contraction is the stroke volume (SV).

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Medagadget

OCTOBER 19, 2023

The technology could make it easier and faster to identify early-stage gingivitis, which can lead to periodontitis and eventual tooth loss, as well as contributing to a variety of other diseases such as stroke and heart disease.

Point-of-Care Testing 86

Point-of-Care Testing Research Stroke Wellness 86

The Skeptics' Guide to EM

MAY 23, 2020

Endovascular thrombectomy with or without intravenous alteplase in acute stroke. Endovascular thrombectomy with or without intravenous alteplase in acute stroke. hours of right sided weakness as well as slurred speech. hours of right sided weakness as well as slurred speech. Date: May 19th, 2020 Reference: Yang P et al.

Stroke 40

Stroke EMS Administration Wellness 40

Taming the SRU

SEPTEMBER 27, 2023

These landmark studies in EM review targeted and systemic thrombolytics in patients with MI, stroke, and PE. Ischemic strokes and endovascular therapy IMS-3: In those with moderate to severe ischemic stroke who received tPA, there was no difference in those who underwent endovascular therapy and those who did not. Cpc WITH drs.

Stroke 52

Stroke EMS Pediatrics Outcomes 52

Emergency Medicine Ireland

APRIL 29, 2024

Hopefully what follows will provide enough broad brush strokes to get you through a night on call or even worse a viva. The sodium rises, the patient stops seizing everyone relaxes but then the Na continues to rise, well above the 5mmol we wanted and a panic ensues. We’ll start with truly emergent situations.

Seizures 75

Seizures Sepsis Stroke Administration 75

American Medical Compliance

FEBRUARY 22, 2024

Mental health encompasses our emotional, psychological, and social well-being. For example, depression raises the chance of a variety of physical health issues, particularly long-term illnesses such as diabetes, heart disease, and stroke. To become certified, please visit us at: American Medical Compliance (AMC).

Teamwork 52

Teamwork Stroke Wellness 52

Sensible Medicine

SEPTEMBER 4, 2023

Well, not really a journalist, more like an opinion writer and critical appraiser. Specifically, if a frail patient was doing well on Vitamin K antagonists (similar to warfarin), should they be switched to the newer direct acting oral anticoagulant (DOACs, such as apixaban or rivaroxaban). For me, one study stood out at ESC.

Wellness 99

Wellness Stroke 99

PulmCCM

FEBRUARY 26, 2024

Tenecteplase for acute ischemic stroke presenting after 4.5 Because it can be infused more rapidly than alteplase, TNK is gaining prominence as thrombolytic treatment for acute ischemic stroke, in patients presenting within 4.5 hours of their last time known to be well. hours after the onset of stroke).

Stroke 40

Stroke Hospitals Psychiatric CDC 40

American Medical Compliance

JULY 31, 2023

GERD, stroke, head or spinal cord damage, and cancer of the head, neck, or esophagus are a few of these. However, a stroke or other neurological condition may make it challenging to trigger the swallowing reflex, a stimulation that enables food and liquids to pass safely through the throat.

Stroke 52

Stroke Burns Wellness 52