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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

Thrombolytic therapy-associated acute myocardial infarction in patients with acute ischemic stroke: A treatment dilemma
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events.
Source: The American Journal of Emergency Medicine - November 21, 2016 Category: Emergency Medicine Authors: Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai Source Type: research

Patients with Acute Coronary Syndrome and Stroke Throughout the Acute Healthcare Chain
For patients with acute coronary syndrome (ACS) and stroke, prompt diagnosis and treatment is essential. In most cases of myocardial infarction, blood flow needs to be restored through percutaneous coronary intervention (PCI) or through thrombolytic medications. Treatments are most effective if started as early as possible. For patients with ST-elevated myocardial infarction (STEMI), PCI should be started within 90 min. For ischemic stroke patients, thrombolysis with recombinant tissue plasminogen activator needs to be given within 4.5 h after onset of symptoms. Before a patient reaches a PCI center or stroke unit, he may ...
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: R. Egberink, M. Zwerink, H. Droste, P. Brouwers, G. Van Houwelingen, C. Doggen Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Rescue thrombolysis in the treatment of cardiac shock and acute stroke
The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ...
Source: The American Journal of Emergency Medicine - April 19, 2013 Category: Emergency Medicine Authors: Sukru Akyuz, Mustafa Azmi Sungur, Cevdet Donmez, Aylin Sungur, Nese Cam Tags: Case Reports Source Type: research