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Total 89 results found since Jan 2013.

Management of Bleeding Complications in Patients Taking Direct Oral Anticoagulants at a Large Tertiary Academic Medical Center
Abstract Direct oral anticoagulants (DOACs) offer a fixed-dose alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, there is minimal evidence to guide the management of bleeding in patients taking a DOAC. We retrospectively evaluated the acute management of major bleeding in this patient population at a large, tertiary academic medical center. We evaluated various strategies of management including dialysis, transfusions, pharmacologic agents, surgical intervention, and reinitiation of anticoagulation. We also assessed length of intensive care unit and hospital stay, mor...
Source: Current Emergency and Hospital Medicine Reports - June 13, 2015 Category: Emergency Medicine Source Type: research

Effects of Fully Accessible Magnetic Resonance Imaging in the Emergency Department
ConclusionsEmergency MRI utilization increased substantially after placement of a fully accessible MRI in the ED. Patients receiving emergency MRI had increased ED LOS, decreased admission rates for some patients (rule‐out stroke), and reduced hospital LOS for those admitted. Potential changes in ED patient resource utilization should be considered when determining whether to acquire an MRI for Comprehensive Stroke Center certification.
Source: Academic Emergency Medicine - May 21, 2015 Category: Emergency Medicine Authors: Vanessa Redd, Scott Levin, Matthew Toerper, Amanda Creel, Susan Peterson Tags: Original Contribution Source Type: research

Cost‐effectiveness of Quantitative Pretest Probability Intended to Reduce Unnecessary Medical Radiation Exposure in Emergency Department Patients With Chest Pain and Dyspnea
ConclusionsWidespread use of a combined qPTP for both ACS and PE has the potential to decrease costs by reducing diagnostic testing, while improving most long‐term outcomes in emergency patients with chest pain and dyspnea.
Source: Academic Emergency Medicine - April 21, 2015 Category: Emergency Medicine Authors: Jennifer L. Troyer, Alan E. Jones, Nathan I. Shapiro, Alice M. Mitchell, Ian Hewer, Jeffrey A. Kline Tags: Original Contribution Source Type: research

Predictors of Patients Who Present to the Emergency Department With Sepsis and Progress to Septic Shock Between 4 and 48 Hours of Emergency Department Arrival*
Conclusion: Approximately 12% of septic emergency department patients develop shock within 48 hours of presentation, and more than half of these patients develop shock after the first 4 hours of emergency department arrival. Over a third of patients who have sepsis within 4 hours of emergency department arrival and develop septic shock between 4 and 48 hours of emergency department arrival are not admitted to an ICU.
Source: Critical Care Medicine - April 17, 2015 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Iodinated Contrast Prior to Thrombolysis Was Not Associated With Worse Intracranial Hemorrhage
ConclusionsNo consistent harms were observed in association with intravenous iodinated contrast prior to rt‐PA administration. It is reasonable to continue CTA prior to thrombolysis as clinically indicated.
Source: Academic Emergency Medicine - March 2, 2015 Category: Emergency Medicine Authors: Ryan P. Radecki, Arif Azam, Pratik B. Doshi, Rosa C. Banuelos Tags: Original Contribution Source Type: research

Race and Sex Disparities in Prehospital Recognition of Acute Stroke
ConclusionsSignificant disparities exist in prehospital stroke recognition.
Source: Academic Emergency Medicine - February 25, 2015 Category: Emergency Medicine Authors: Prasanthi Govindarajan, Benjamin T. Friedman, James Q. Delgadillo, David Ghilarducci, Lawrence J. Cook, Barbara Grimes, Charles E. McCulloch, S. Claiborne Johnston Tags: Original Contribution Source Type: research

Otitis Media Leads to Brain Abscess Presenting as Stroke
By Mikhail Elfond, DO; Esi Quayson, MD; & Joseph V.M. Kelly, MD, MBA A 65-year-old man presented to the ED via EMS with symptoms of stroke. The paramedics stated his right-sided weakness and speech difficulty started 40 minutes prior to presentation in the ED. En route to the hospital, paramedics observed four episodes of facial twitching.       Vitals signs were significant for a rectal temperature of 100.2°F and a fingerstick blood sugar of 220 mg/dL. History of present illness was significant for a diagnosis of left otitis media treated with Augmentin and Vicodin at an urgent care center ...
Source: The Case Files - January 20, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Identification of Acute Stroke Using Quantified Brain Electrical Activity
ConclusionsDespite a small population and the use of a classifier without the benefit of training on a stroke population, these data suggest that a rapidly acquired, easy‐to‐use system to assess brain electrical activity at the time of evaluation of acute stroke could be a valuable adjunct to current clinical practice.
Source: Academic Emergency Medicine - January 6, 2015 Category: Emergency Medicine Authors: Edward A. Michelson, Daniel Hanley, Robert Chabot, Leslie S. Prichep Tags: Original Contribution Source Type: research

Identification of acute stroke using quantified brain electrical activity.
CONCLUSIONS: Despite a small population and the use of a classifier without the benefit of training on a stroke population, these data suggest that a rapidly acquired, easy-to-use system to assess brain electrical activity at the time of evaluation of acute stroke could be a valuable adjunct to current clinical practice. PMID: 25565489 [PubMed - in process]
Source: Accident and Emergency Nursing - January 1, 2015 Category: Emergency Medicine Authors: Michelson EA, Hanley D, Chabot R, Prichep LS Tags: Acad Emerg Med Source Type: research

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease.
Abstract Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group...
Source: Accident and Emergency Nursing - November 24, 2014 Category: Emergency Medicine Authors: Madsen TE, Seigel TA, Mackenzie RS, Marcolini EG, Wira CR, Healy ME, Wright DW, Gentile NT Tags: Acad Emerg Med Source Type: research

Sex- and Gender-specific Research Priorities for the Emergency Management of Heart Failure and Acute Arrhythmia: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.
This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in seven priorit...
Source: Accident and Emergency Nursing - November 24, 2014 Category: Emergency Medicine Authors: McGregor AJ, Frank Peacock W, Marie Chang A, Safdar B, Diercks D Tags: Acad Emerg Med Source Type: research

Sex‐ and Gender‐specific Research Priorities for the Emergency Management of Heart Failure and Acute Arrhythmia: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup
This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference “Gender‐Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes.” A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in‐person meetings, and Web‐based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in sev...
Source: Academic Emergency Medicine - November 24, 2014 Category: Emergency Medicine Authors: Alyson J. McGregor, W. Frank Peacock, Anna Marie Chang, Basmah Safdar, Deborah Diercks Tags: Proceedings Breakout Session Source Type: research

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease
Abstract Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group of ED re...
Source: Academic Emergency Medicine - November 24, 2014 Category: Emergency Medicine Authors: Tracy E. Madsen, Todd A. Seigel, Richard S. Mackenzie, Evie G. Marcolini, Charles R. Wira, Megan E. Healy, David W. Wright, Nina T. Gentile Tags: Proceedings Breakout Session Source Type: research

Computed Tomography Abnormalities and Epidemiology of Adult Patients Presenting With First Seizure to the Emergency Department in Qatar / Epidemiología y Alteraciones en la Tomografía Computarizada de los Pacientes Adultos Atendidos por una Primera Crisis Epiléptica en un Servicio de Urgencias en Qatar.
ConclusionsAdults who presented with first seizure to the ED in Qatar had a young male predominance, and a high proportion of brain CT scans were reported as abnormal. It is recommended that all such patients in this population should undergo prompt CT scanning in the ED, but the utility of routine electrolyte tests requires further investigation. Resumen ObjetivosExisten poco datos de la región del Medio Este del mundo en pacientes atendidos con una primera crisis epiléptica. Los objetivos de este estudio fueron describir las características epidemiológicas de los pacientes atendidos en el servicio de urgencias (SU) ...
Source: Academic Emergency Medicine - November 6, 2014 Category: Emergency Medicine Authors: Sameer A. Pathan, Salem Abosalah, Sana Nadeem, Amjad Ali, Asma A. Hameed, Mandar Marathe, Peter A. Cameron Tags: Original Contribution Source Type: research

The Stroke Book, 2nd Edition. Michel T. Torbey, MD, MPH, and Magdy H. Selim, MD, PhD. Cambridge, UK: Cambridge University Press, 2013; 380 pp; $59.95 (softcover).
Source: Academic Emergency Medicine - September 30, 2014 Category: Emergency Medicine Authors: Kathleen Cowling, Warren Singleton Tags: Media Reviews Source Type: research