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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

Neurology Concepts: Young Women and Ischemic Stroke: Evaluation and Management in the Emergency Department
ConclusionUnique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 24, 2017 Category: Emergency Medicine Authors: Bernard P. Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E. Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen Tags: Original Contribution Source Type: research

Neurology Concepts: Young Women and Ischemic Stroke —Evaluation and Management in the Emergency Department
ConclusionUnique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.
Source: Academic Emergency Medicine - October 10, 2017 Category: Emergency Medicine Authors: Bernard P. Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E. Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen Tags: Original Contribution Source Type: research

HINTS Outperforms ABCD2 to Screen for Stroke in Acute Continuous Vertigo and DizzinessEl HINTS Supera el ABCD2 en el Despistaje del Ictus en los Pacientes con Vértigo y Mareo Agudos Persistentes
ConclusionsHINTS substantially outperforms ABCD2 for stroke diagnosis in ED patients with AVS. It also outperforms MRI obtained within the first 2 days after symptom onset. While HINTS testing has traditionally been performed by specialists, methods for empowering emergency physicians (EPs) to leverage this approach for stroke screening in dizziness should be investigated. Resumen ObjetivosEl mareo y el vértigo contabilizan aproximadamente 4 millones de visitas anuales a los servicios de urgencias (SU) en Estados Unidos, y de 160.000 a 240.000 (4% al 6%) tienen un origen cerebrovascular. El diagnóstico de ictus en los ...
Source: Academic Emergency Medicine - October 15, 2013 Category: Emergency Medicine Authors: David E. Newman‐Toker, Kevin A. Kerber, Yu‐Hsiang Hsieh, John H. Pula, Rodney Omron, Ali S. Saber Tehrani, Georgios Mantokoudis, Daniel F. Hanley, David S. Zee, Jorge C. Kattah Tags: Original Research 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

The Association Between Emergency Department Crowding and the Disposition of Patients With Transient Ischemic Attack or Minor Stroke
ConclusionsThese results suggest that crowding may influence clinical decision‐making in the disposition of patients with TIA or minor stroke and that, as crowding worsens, the likelihood of hospitalization increases.
Source: Academic Emergency Medicine - September 1, 2015 Category: Emergency Medicine Authors: Maxim Ben‐Yakov, Moira K. Kapral, Jiming Fang, Shudong Li, Marian J. Vermeulen, Michael J. Schull Tags: Original Contribution Source Type: research

Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine
ConclusionsGiven the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund the up‐front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care.
Source: Academic Emergency Medicine - December 31, 2015 Category: Emergency Medicine Authors: Elham Torabi, Craig M. Froehle, Christopher J. Lindsell, Charles J. Moomaw, Daniel Kanter, Dawn Kleindorfer, Opeolu Adeoye Tags: Original Contribution Source Type: research

Potentially Missed Diagnosis of Ischemic Stroke in the Emergency Department in the Greater Cincinnati/Northern Kentucky Stroke Study
ConclusionIn a large population‐based sample of AIS cases, 1 in 7 cases were not diagnosed as AIS in the ED, but the impact on acute treatment rates is likely small. Missed diagnosis was more common among those with decreased LOC, suggesting the need for improved diagnostic approaches in these patients.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 16, 2016 Category: Emergency Medicine Authors: Tracy E. Madsen, Jane Khoury, Rhonda Cadena, Opeolu Adeoye, Kathleen A. Alwell, Charles J. Moomaw, Erin McDonough, Matthew L. Flaherty, Simona Ferioli, Daniel Woo, Pooja Khatri, Joseph P. Broderick, Brett M. Kissela, Dawn Kleindorfer Tags: Original Contribution Source Type: research

Patient and process factors associated with type of first neuroimaging and delayed diagnosis in childhood arterial ischemic stroke
ConclusionsStrategies to improve rapid diagnosis of pediatric stroke should include shared regional hospital networks protocols to optimize local imaging strategies, and where possible rapid transfer to the tertiary center. Future priorities should include development of pediatric ED physician decision support tools to differentiate stroke from mimics, and the development and implementation of rapid ED imaging stroke protocols to improve access to confirmatory MRI scanning.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - May 6, 2016 Category: Emergency Medicine Authors: Marco Daverio, Silvia Bressan, Dario Gregori, Franz E. Babl, Mark T. Mackay Tags: Original Contribution Source Type: research

Implementation of a Dedicated Cardiovascular and Stroke Unit in a Crowded Emergency Department of a Tertiary Public Hospital in Brazil: Effect on Mortality Rates / Implementación de una Unidad Destinada a Ictus y Patología Cardiovascular (Unidad Vascular) en un Servicio de Urgencias Saturado de un Hospital Público Terciario en Brasil: Impacto en los Porcentajes de Mortalidad
ConclusionsThe vascular unit strategy has the potential to reduce overall mortality for most acute vascular conditions. Resumen IntroducciónLa atención del servicio de urgencias (SU) a las enfermedades vasculares agudas se enfrenta al reto de la saturación. Una unidad vascular es una unidad protocolizada y especializada en el SU con un equipo formado para el manejo de los trastornos vasculares agudos, que incluye el ictus, los síndromes coronarios, el embolismo de pulmón (EP) y las enfermedades aórticas. ObjetivosComparar las tasas de mortalidad para las enfermedades cardiovasculares seleccionadas antes y después d...
Source: Academic Emergency Medicine - January 6, 2014 Category: Emergency Medicine Authors: Luiz A. Nasi, Andre L. Ferreira‐Da‐Silva, Sheila C.O. Martins, Mariana V. Furtado, Andrea G. Almeida, Rosane Brondani, Letícia Wirth, Marisa Kluck, Carisi A. Polanczyk Tags: Original Research Contribution Source Type: research

Does Preexisting Antiplatelet Treatment Influence Postthrombolysis Intracranial Hemorrhage in Community‐treated Ischemic Stroke Patients? An Observational Study
ConclusionsThe authors did not find that preexisting antiplatelet use was associated with postthrombolysis ICH or sICH in this cohort of community treated patients. Preexisting tobacco use, younger age, and lower severity were associated with lower odds of sICH. The meta‐analyses demonstrated small, but statistically significant increases in the absolute risk of radiographic ICH and sICH, along with increased odds of sICH in patients with preexisting antiplatelet use. Resumen ¿Influye el Tratamiento Antiagregante Previo en la Hemorragia Intracraneal tras la Trombolisis en los Pacientes con Ictus Isquémicos Tratados en...
Source: Academic Emergency Medicine - February 13, 2013 Category: Emergency Medicine Authors: William J. Meurer, Heemun Kwok, Lesli E. Skolarus, Eric E. Adelman, Allison M. Kade, Jack Kalbfleisch, Shirley M. Frederiksen, Phillip A. Scott Tags: Original Research Contribution Source Type: research

Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays
ConclusionsUp to 31% of patients have delays due to medical or eligibility‐related causes that may be legitimate reasons for providing alteplase later than the benchmark time of 60 minutes.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - January 29, 2016 Category: Emergency Medicine Authors: Philip M C Choi, Jamsheed A Desai, Devika Kashyap, Caroline Stephenson, Noreen Kamal, Sheldon Vogt, Victoria Bohm, Michael Suddes, Erin Bugbee, Michael D Hill, Andrew M Demchuk, Eric E Smith Tags: Original Contribution 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

Assessing Fluid Responsiveness in Spontaneously Breathing Patients
ConclusionsNoninvasive assessment of fluid responsiveness in healthy volunteers and prediction of this response with a PLR maneuver is achievable. Further work is indicated to test these methods in acutely ill patients.
Source: Academic Emergency Medicine - January 14, 2016 Category: Emergency Medicine Authors: Joseph Miller, Chuan‐Xing Ho, Joy Tang, Richard Thompson, Jared Goldberg, Ahmed Amer, Bashar Nahab Tags: Original Contribution 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

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