• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke
This study hypothesized that extending the time window for thrombolytic therapy to 9 hours after onset of symptoms in patients with a small core of infarction and a larger area of hypoperfusion would be beneficial.
Source: The Journal of Emergency Medicine - July 31, 2019 Category: Emergency Medicine Authors: Matthew W. Harrison, Amanda Young Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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

Mobile Stroke Units: A Device in Search of an Indication
If you've been to any regional or national EMS conference in the last two years, you've seen these mobile stroke units. They are beautiful large ambulances with the latest and greatest in modern technology including mobile CT scanners. Often, the name of a hospital is blazoned on the side. There is usually a staff member present to tell you how great these will be for your community. But are they? Where's the science? What's the cost? These are important questions that should be asked and answered before these devices are deployed on a widespread basis. Although still somewhat controversial, therapies are now available to ...
Source: JEMS Patient Care - January 12, 2017 Category: Emergency Medicine Authors: Bryan Bledsoe, DO, FACEP, FAEMS Tags: Patient Care Source Type: news

Evaluation and Management of the Child With Suspected Acute Stroke
Pediatric stroke occurs at an incidence of 1.6 to 13/100 000 and may be acute ischemic, hemorrhagic, or of sinus venous thrombosis etiology. As these children present to the emergency department, early consideration for this diagnosis is paramount in beginning medical management to optimize cerebral perfusion and minimize secondary injury. There are many identified risk factors in pediatric stroke including arteriopathies, cardiac disease (specifically congenital heart disease), and infection. Modifiable adult risk factors including hypertension, hyperlipidemia, and diabetes are rarely seen in pediatrics.
Source: Clinical Pediatric Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Lindsey Morgan Source Type: research

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke
We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Chen-Hsiung Huang, Hui-Chun Huang, Kang-Hsu Lin, Wei-Kung Chen, Chon-Haw Tsai Tags: Case Reports Source Type: research