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Are anti-coagulated elderly head injured patients at risk for delayed intracranial hemorrhage?

University of Maryland Department of Emergency Med

This study looked at 69,321 head injured patients over age 65 in a health care database for delayed intracranial hemorrhage (within 90 days of vi. Click to view the rest

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What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

NOTE: Virtually all of the above ECG features are seen in the 2 tracings from today’s case ( See Figure-1 ). ECG #1 ( Bottom tracing in Figure-1 ): The most remarkable finding in this initial ECG is the baseline artifact that is seen in virtually all 12 leads!

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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

Muir et al published a Bedside Evaluation of Neuro State of Kids with DKA : Diagnostic Criteria Abnormal motor or verbal response to pain Decorticate or Decerebrate posture Cranial Nerve Palsy (especially III, IV, or VI) Abnormal neurologic respiratory pattern (grunting, Cheyne-Stokes, etc) Major Criteria Altered mentation, confusion, fluctuating level (..)

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Lab Case 42

EMergucate

A 36 year old man presents to your ED with epigastric pain, right upper quadrant pain and vomiting. He admits to drinking excessive amounts of alcohol but denies any alcohol for the past 4 days.

EMS 40
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EM@3AM: Extensor Tendon Laceration

EMDocs

Answer : Extensor tendon laceration Epidemiology: Hand extensor injuries make up >25% of orthopedic soft tissue injuries 2, 3 Common in young men in manual labor Dominant hand more likely to be injured 4 2012 study on 86 patients reported 83% men with a mean age of 34.2

EMS 76
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EM@3AM: Brainstem Strokes

EMDocs

Risk factors : 10% of ischemic strokes occur in the brainstem 2 Risk factors for ischemic brainstem stroke 3 : Atherosclerosis Hypertension Diabetes Smoking Atrial fibrillation Hyperlipidemia Ischemic heart disease Embolism Dissection Risk variables for hemorrhagic brainstem strokes 3 : Hypertension Anticoagulant use AV malformations Amyloid angiopathy (..)

Stroke 79
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An Unusual Bradycardia

Dr. Smith's ECG Blog

Common explanations for unusual rhythms such as this one include: i ) Hyperkalemia ( or other severe electrolyte disorder ); ii ) Recent infarction/ischemia; iii ) Sleep apnea; iv ) Severe hypothyroidism; v ) Acute neurologic catastrophe (ie, stroke, bleed, trauma, tumor ); vi ) Some other toxicity.

EKG/ECG 52