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Specialty: Emergency Medicine
Education: Teaching

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Total 25 results found since Jan 2013.

A multi-modal approach to quality improvement: reducing 'door-to-ct' time in potenitally thombolysable stroke patients
Conclusion Early thrombolysis has been shown to improve outcomes in patients with ischaemic stroke.2 Reducing ‘Door-to-CT' scan time in the ED is an important step in enabling a reduction in the overall DTN time. This can be achieved by stream-lining key processes in the patient journey through the ED. A multi-modal approach ensured this change was introduced safely and effectively whilst re-enforcing a core change to standard working practice. Further work on process mapping and the delivery of thrombolysis is the next obvious step in further reduction in DTN time. Figure 1Quality Improvement Run Chart 'Door-t...
Source: Emergency Medicine Journal - November 17, 2016 Category: Emergency Medicine Authors: Waterson, F., Braithwaite, I., Tuck, I., Alcock, R. Tags: Stroke, Radiology, Clinical diagnostic tests, Radiology (diagnostics) RCEM Lightning presentations Source Type: research

The accuracy of surrogate decision makers: informed consent in hypothetical acute stroke scenarios
Conclusions: Surrogates accurately predict patient preferences for standard acute stroke treatments. However, the accuracy decreases when predicting research participation suggesting that the degree of surrogate agreement is dependent on the type of decision being made. Further research is needed to more thoroughly characterize surrogate decision-making in acute stroke situations.
Source: BMC Emergency Medicine - November 13, 2013 Category: Emergency Medicine Authors: Jessica BryantLesli SkolarusBarbara SmithEric AdelmanWilliam Meurer Source Type: research

Electrocardiogram Changes as an Independent Predictive Factor of Mortality in Patients with Acute Ischemic Stroke; a Cohort Study.
Conclusion: Based on the findings of the present study, it seems that along with age and history of cardiac diseases, ECG changes can be considered as an independent predictive factor of mortality in patients with ischemic stroke. PMID: 31432037 [PubMed]
Source: Accident and Emergency Nursing - August 24, 2019 Category: Emergency Medicine Authors: Asadi P, Zia Ziabari SM, Naghshe Jahan D, Jafarian Yazdi A Tags: Arch Acad Emerg Med Source Type: research

Nonconvulsive status epilepticus masquerading as stroke
This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in nonconvulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Christopher Kennel, Andreas Michas-Martin, Brian D. Berman, Sharon Poisson Tags: Case Report Source Type: research

Risk factors for medical complications of acute hemorrhagic stroke
Conclusions Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.\
Source: Journal of Acute Disease - August 4, 2015 Category: Emergency Medicine Source Type: research

Debilitating Headache after an Excited Reaction
​BY GREGORY TAYLOR, DO, & MATTHEW WARPINSKI, DOA 35-year-old man with a history of uncontrolled hypertension and medical noncompliance was brought to the emergency department by EMS complaining of a headache. The family said the patient was watching football and developed an acute headache after he stood up screaming in excitement.His family said he had not taken his blood pressure medication for years. He was afebrile, his blood pressure was 245/129 mm Hg, his respiratory rate was 18 bpm, his heart rate was 68 bpm, and he weighed 340 pounds. The patient was obtunded with a Glasgow Coma Scale score of 4 and was subse...
Source: The Case Files - November 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

ECG Educational Standards for Prehospital Providers
Conclusion As the role of evidence-based medicine becomes more prominent in the field of emergency medicine, a clear view of the current state of ECG education and platform from which to implement uniform standards becomes increasingly essential; especially as research expands into the prehospital setting. Further research into EMS education may identify both strengths and weaknesses in basic ECG interpretation appropriate for first responders. Implementing minimum ECG interpretation standards for EMS personnel nationwide is one potential option to ensure prehospital educational institutions stay responsive to current scie...
Source: JEMS Special Topics - November 27, 2018 Category: Emergency Medicine Authors: Jonathan Barney, BA, EMT, MS3 Tags: Training Exclusive Articles Cardiac & Resuscitation Source Type: news

Diagnostic Value of S100B Protein in the Differential Diagnosis of Acute Vertigo in the Emergency Department / El Valor Diagnóstico de la Proteína S100B en el Diagnóstico Diferencial del Vértigo Agudo en el Servicio de Urgencias
ConclusionsTo the best of our knowledge this is the first study assessing the utility of serum S100B levels for diagnosis of acute‐onset vertigo. Serum S100B levels are associated with the presence of central causes of vertigo on cranial MRI. However, serum S100B levels are not sufficiently sensitive to exclude candidates from cranial MRI. Resumen ObjetivosEl vértigo es un motivo de consulta frecuente y es consecuencia de una etiología central o periférica. Debido a que las causas centrales pueden ser de riesgo vital, la determinación de la naturaleza del vértigo es crucial en el servicio de urgencias (SU). Con un ...
Source: Academic Emergency Medicine - August 13, 2014 Category: Emergency Medicine Authors: Aslı Gülfer Kartal, Serkan Yılmaz, Elif Yaka, Murat Pekdemir, Hasan Tahsin Sarısoy, Mustafa Baki Çekmen, Melih Yüksel Tags: Original Contribution Source Type: research

Prevalence and Risk Factors of Stress Cardiomyopathy After Convulsive Status Epilepticus in ICU Patients
Objective: Although stress cardiomyopathy has been described in association with epilepsy, its frequency in patients with convulsive status epilepticus remains unknown. Accordingly, we sought to determine the prevalence and risk factors of stress cardiomyopathy in patients admitted to the ICU for convulsive status epilepticus. Design: Prospective, descriptive, single-center study. Setting: Medical-surgical ICU of a teaching hospital. Patients: Thirty-two consecutive ventilated patients (21 men; age, 50 ± 18 yr; Simplified Acute Physiology Score II, 53 ± 15; Sequential Organ Failure Assessment, 6 ± 2) hospitalized in the...
Source: Critical Care Medicine - September 18, 2015 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Pre-hospital emergency skills for medical students
Conclusion These results show that there is some anxiety amongst students about being able to manage pre-hospital emergencies in which the public might expect them to cope or in which they feel obliged to help. The results show that although students would be willing to help they may not posess the necessary knowledge to do so. They show that there is a demand for teaching focussed on these skills but that there is not necessarily a need for it taking into account the frequency of incidents encountered. A trial teaching programme will take place in July.
Source: Emergency Medicine Journal - November 23, 2015 Category: Emergency Medicine Authors: Wheeler, C. Tags: Stroke RCEM LIGHTNING PRESENTATIONS Source Type: research

Trauma & Triage Geriatric Teaching Moments from A.J. Heightman, MPA, EMT-P – JEMS Editor-in-Chief relative to the Texas Church Mini Bus Crash that Killed 13 Senior Citizens
When 13 senior citizens were killed in a horrible head-on collision between a San Antonio church mini bus and a pickup truck in southwest Texas, the AP story noted that the elderly occupants “were more susceptible to internal injuries and damage to vulnerable organs because of their advanced ages.” (see below as presented by the Associated Press). As an educator who spends a lot of time educating crews about the unique impact trauma can have on geriatric patients, I thought I would take the opportunity to present a few important facts about geriatric trauma and assessment tips to remember when you are tasked with triag...
Source: JEMS Patient Care - April 2, 2017 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT P Tags: Major Incidents News Category Orientation Patient Care Source Type: news

Is it an Emergency? Insurer Asks Patients to Question ED Visits
INDIANAPOLIS (AP) — Alison Wrenne was making waffles for her two young children one morning when abdominal pain forced her to the floor. A neighbor who is a physician assistant urged her to go to the emergency room. Wrong decision, according to her health insurer. Wrenne was diagnosed with a ruptured ovarian cyst, but Anthem said that wasn't an emergency and stuck her with a $4,110 bill. "How are you supposed to know that?" said the 34-year-old from Lexington, Kentucky. "I'm not a doctor ... that's what the emergency room is for." In an effort to curb unnecessary and costly ER visits, the Blue Cross-B...
Source: JEMS Patient Care - November 10, 2017 Category: Emergency Medicine Authors: Tom Murphy, Associated Press Tags: Patient Care News Administration and Leadership Source Type: news