Research and Reviews in the Fastlane 088

This article seeks to protocolize this modality into 5 specific assessments (the “5Es”): Pericardial Effusion, Qualitative Left Ventricular Ejection Fraction, Ventricular Equality, Exit (Aortic Root measurement/assessment) and Entrance (IVC diameter and respirophasic variation). This approach is a nice way to remind clinicians of all the areas EP FOCUS can assess. The article also highlights a number of pitfalls that can lead to misdiagnosis that are critical to understand. Recommended by Anand Swaminathan Critical CareJovin TG et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. NEJM 2015. PMID 25882510 The REVASC trial planned to enroll 690 patients presenting to the Emergency Department in 4 centers across Catalonia with symptoms consistent with a large vessel stroke that could be treated with endovascular therapy within 8 hours of symptom onset. Unlike EXTEND-IA, ESCAPE or SWIFT-PRIME, the REVASCAT Trial did not use perfusion imaging to select patients with favorable areas of salvageable tissue. Rather employed CTA to identify occlusion in the ICA or M1 branch of the MCA, and utilized the less accurate ASPECT score, derived from the initial non-contrast CT, to assess potential for viable ischemic tissue. REVASCAT enrolled 206 patients before its premature termination. And like the three trials before it demonstrated a statistically significant improvement in mRS at 90 days in the patients who underwent endovascular therapy. The REVASC...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: R&R in the FASTLANE critical care Education Emergency Medicine examination Intensive Care research and reviews Source Type: blogs