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Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the p...
Source: JEMS Patient Care - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Resuscitation & Shock Special Topics Research Columns Patient Care Source Type: news

Analgesia in Neurocritical Care: An International Survey and Practice Audit*
Conclusions: Opiates and acetaminophen are preferred analgesic agents, and gabapentin is a contextual third choice, in neurocritically ill patients. Other agents are rarely prescribed. The discordance in physician self-reports and objective audits suggest that pain management optimization studies are warranted.
Source: Critical Care Medicine - April 16, 2016 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the p...
Source: JEMS Special Topics - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Special Topics Cardiac & Resuscitation Columns Patient Care Source Type: news

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomography (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurological outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Source Type: research

Should we be looking for and treating isolated calf vein thrombosis?
Management of isolated calf deep vein thrombosis is an area of significant international debate and variable clinical practice. Both therapeutic anticoagulation and conservative management carry risk. As clinical care of suspected and confirmed venous thromboembolic disease increasingly becomes the remit of emergency medicine, complex decisions are left to practising clinicians at the front door. We aim to provide a contemporary overview of recent evidence on this topic and associated challenges facing clinicians. Given the lack of high-level evidence, we present this work as a narrative review, based on structured literat...
Source: Emergency Medicine Journal - May 18, 2016 Category: Emergency Medicine Authors: Horner, D., Hogg, K., Body, R. Tags: Drugs: cardiovascular system, Stroke, Pregnancy, Venous thromboembolism, Pulmonary embolism Review Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomographic (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurologic outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Tags: Case Report Source Type: research

Neurologic Emergencies in the Elderly
This article discusses the elderly patient presenting to the emergency department with acute ischemic stroke, transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, chronic subdural hematoma, traumatic brain injury, seizures, and central nervous system infections. This article reviews the subtle presentations, difficult workups, and complicated treatment decisions as they pertain to our older patients. ”
Source: Emergency Medicine Clinics of North America - July 28, 2016 Category: Emergency Medicine Authors: Lauren M. Nentwich, Benjamin Grimmnitz Source Type: research

Diagnosis and Management of Acute Intracerebral Hemorrhage
This article provides an updated review on ICH diagnosis and management in the emergency department.
Source: Emergency Medicine Clinics of North America - September 2, 2016 Category: Emergency Medicine Authors: Andrea Morotti, Joshua N. Goldstein Source Type: research

Intracerebral hemorrhage in a middle aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman with a not declared at admission with a 4 year history of intranasal cocaine hydrochloride who developed an intracerebral subcortical spontaneous hemorragie. She documented a normal blood pressure and a CT angiography did not shown vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Intracerebral hemorrhage in a middle-aged cocaine user despite normal blood pressures
We report the case of a 40-year-old woman who did not declare at admission her 4-year history of intranasal cocaine hydrochloride and developed an intracerebral subcortical spontaneous hemorrhage. She documented a normal blood pressure, and computer tomography angiography did not show vascular abnormalities and excluded the presence of arterial aneurisms.
Source: The American Journal of Emergency Medicine - September 2, 2016 Category: Emergency Medicine Authors: Antonio Siniscalchi, Walter Lentidoro, Ermanno Pisanil, Giovamabattista De Sarro, Luca Gallelli Tags: Case Report Source Type: research

Oral anticoagulants for stroke prevention in patients with atrial fibrillation and previous intracranial hemorrhage
Source: Internal and Emergency Medicine - November 3, 2016 Category: Emergency Medicine Source Type: research

Central venous sinus thrombosis presenting with generalized tonic-clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurological examination. Her head computed tomography (CT) showed an intraparenchymal hemorrhage of the left frontal lobe and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 9, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin L. Simon Tags: Case Reports Source Type: research

Hypothermia for Neuroprotection in Convulsive Status Epilepticus
This study aims to see if there are any similar advantages to therapeutic hypothermia in mechanically ventilated status epilepticus patients as neuroprotective properties were previously detected in animal studies of hypothermia.
Source: The Journal of Emergency Medicine - February 17, 2017 Category: Emergency Medicine Authors: Stephanie Diebold Tags: Abstract Source Type: research

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