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Specialty: Emergency Medicine
Condition: Hemorrhagic Stroke
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Total 233 results found since Jan 2013.
Prophylactic Seizure Medication and Health-Related Quality of Life After Intracerebral Hemorrhage
Objectives:
Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function health-related quality of life.
Design:
Patients with intracerebral hemorrhage were enrolled in a prospective cohort study. We performed mixed models for T-scores of health-related quality of life, referenced to the U.S. population at 50 ± 10, accounting for severity of injury and time to follow-up.
...
Source: Critical Care Medicine - August 16, 2018 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research
Presentation of Acute Childhood Stroke in a Tertiary Pediatric Emergency Department
Conclusions
The spectrum of stroke in a developing country was similar to published series from developed countries in terms of final diagnosis, risk factors, and delay to ED presentation, neuroimaging, and long-term neurodeficits. No tropical diseases were identified as risk factors.
Source: Pediatric Emergency Care - August 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research
Prospective assessment of patients with stroke in Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia
This study aimed to describe risk factors for stroke and clinical presentation of patients presenting to the emergency centre with stroke.MethodsWe conducted a cross sectional study conducted from August 2015 to January 2016 in an urban tertiary care centre in Addis Ababa, Ethiopia. Descriptive statistics and multivariable logistic regression models were used to evaluate associations between stroke types and stroke risk factors, and delayed presentation and clinical indicators. P-values less than .05 were considered statistically significant.ResultsA total of 104 patients were included. The mean age was 53 years, and 56%...
Source: African Journal of Emergency Medicine - July 10, 2018 Category: Emergency Medicine Source Type: research
Stroke Triage: EMS needs a diagnostic tool that goes beyond a simple history & physical exam
As a young EMT and paramedic, I had relatively little education about acute myocardial infarctions. In the age of the 3-lead ECG, education was largely focused on arrhythmia detection and how to differentiate heart blocks, tachycardia and bradycardia. Detection of heart attack was largely based upon history and physical exam findings.
Three decades later, the thought of relying on a physical exam to diagnose a ST- elevation myocardial infarction (STEMI) is hard to imagine. Although we’ve made remarkable progress in the prehospital detection of STEMI, we’ve made significantly less progress in the diagnosis of acute stro...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Mark E.A. Escott, MD, MPH, FACEP, NRP Tags: Patient Care Columns Source Type: news
Blood Pressure Management Goals in Stroke Care
Blood pressure management goals in stroke care
You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services.
Upon further questioning you determine her headache was sudden onset with maximum intensity.
When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 mmHg; hea...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Ken Davis, BA, EMT-P, FP-C Tags: Patient Care Cardiac & Resuscitation Source Type: news
Severe Symptoms, but a Truly Treatable Disease
BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Lack of Early Improvement Predicts Poor Outcome Following Acute Intracerebral Hemorrhage
Conclusions:
Lack of clinical improvement at 24 hours robustly predicted poor outcome and showed good discrimination for individual patients who would do poorly. These findings are useful for prognostication and may also present as a potential early surrogate outcome for future intracerebral hemorrhage treatment trials.
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
Predictor variables of abnormal imaging findings of syncope in the emergency department
ConclusionsOur data offer that the identification of predictor variables has a potential to decrease the routine use of head CT and MRI in patients admitting to the ED with syncope.
Source: International Journal of Emergency Medicine - March 12, 2018 Category: Emergency Medicine Source Type: research
The Role of Thromboelastography Testing in the Emergency Medicine, Trauma Center, and Critical Care Environments
AbstractPurpose of ReviewThromboelastography (TEG) has been gaining attention for its potential use in a variety of disease of states to guide therapies and determine prognosis. This review will explore recent research specifically regarding the use of thromboelastography in the emergency, trauma, and critical care clinical environments.Recent FindingsThromboelastography has its drawbacks. TEG has wide operator and machine variability. Known coagulopathic states may exhibit normal viscoelastic results, indicating inconsistent results. Thromboelastography has shown to decrease transfusion of blood products in traumatic hemo...
Source: Current Emergency and Hospital Medicine Reports - February 15, 2018 Category: Emergency Medicine Source Type: research
Outcomes in syncope research: a systematic review and critical appraisal
We present a critical analysis of the pros and cons of the commonly considered outcomes, and provide possible solutions to improve their choice in ED syncope studies. We also support global initiatives to promote the standardization of patient management and data collection.
Source: Internal and Emergency Medicine - January 18, 2018 Category: Emergency Medicine Source Type: research
Spontaneous Vertebral Artery Dissection in a Healthy 26 Year Old Female Patient: A Case Study
Spontaneous vertebral artery dissection (SVAD) is an extremely rare, yet life-threatening, event that can potentially result in ischemic stroke or subarachnoid hemorrhage, depending on the origin and extension of the dissection. Vertebral artery dissection is more commonly associated with traumatic injury to the neck, resulting in compromised structural integrity of the vertebral artery wall. This case study discusses the clinical presentation, physical examination, diagnosis, clinical course, and outcome for a young, otherwise healthy, female patient who presented to the emergency department with a SVAD.
Source: Advanced Emergency Nursing Journal - January 1, 2018 Category: Emergency Medicine Tags: Cases of Note Source Type: research
Prospective assessment of patients with stroke in Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia
This study aimed to describe risk factors for stroke and clinical presentation of patients presenting to the emergency centre with stroke. Methods We conducted a cross sectional study conducted from August 2015 to January 2016 in an urban tertiary care centre in Addis Ababa, Ethiopia. Descriptive statistics and multivariable logistic regression models were used to evaluate associations between stroke types and stroke risk factors, and delayed presentation and clinical indicators. P-values less than .05 were considered statistically significant. Results A total of 104 patients were included. The mean age was 53 years, and...
Source: African Journal of Emergency Medicine - December 16, 2017 Category: Emergency Medicine Source Type: research
