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A Shorter Door-In-Door-Out Time Is Associated with Improved Outcome in Large Vessel Occlusion Stroke
We examined the association between DIDO times and 90-day outcomes as measured by the modi fied Rankin scale.Results: A total of 435 patients were included in the final analysis. The mean DIDO time for patients with good outcomes was 17 minute shorter than patients with poor outcomes (122 minutes [min] vs 139 min, P = 0.04)....
Source: Western Journal of Emergency Medicine - August 30, 2023 Category: Emergency Medicine Authors: Sigal, Adam Source Type: research

An analysis of racial inequities in emergency department triage among patients with stroke-like symptoms in the United States
Racial inequities exist in treatment and outcomes in patients with acute stroke.
Source: BMC Emergency Medicine - August 14, 2023 Category: Emergency Medicine Authors: Gabriel Neves, John DeToledo, James Morris and K. Tom Xu Tags: Research Source Type: research

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Neurologic emergencies can be difficult to diagnose and treat, and are devastating if missed. Stroke is still the number five cause of death in the United States, down from number three a few years ago, and is the leading cause of long-term serious disability. Nonconvulsive status epilepticus is a substantial problem in intensive care units. Traumatic brain injuries from head trauma are a leading cause of post-traumatic stress in many populations. Then we have spine injuries, headache, back pain, infections, and vision problems, which present to emergency departments on a daily basis.
Source: The Journal of Emergency Medicine - April 5, 2023 Category: Emergency Medicine Authors: Edward J. Otten Tags: Book and Other Media Reviews Source Type: research

Stroke incidence and outcome disparity in Rural regions of Southern West Virginia
Conclusions: Stroke incidence and mortality were found to be higher than expected in many areas of rural West Virginia. The higher stroke risk populations correlate with area that may be impacted by socioeconomic factors and limited access to primary care. These high-risk areas may therefore benefit from investments in infrastructure, patient education, and unrestricted primary care.
Source: Journal of Emergencies, Trauma and Shock - December 24, 2021 Category: Emergency Medicine Authors: Frank Harrison Annie Mark C Bates Muhammad Khan Salman Zahid Syed Imran Shah Aravinda Nanjundappa Joshua R Wyner Elise Anderson Ali Farooq Megan Wood Abhiram Challa Source Type: research

Squamous Cell Carcinoma of the Neck: An Unlikely Stroke Mimic
Stroke mimics are noncerebrovascular conditions that present with classical stroke symptoms. They account for up to 30% of stroke presentations in the emergency department (ED). Emergency physicians are faced with a diagnostic dilemma —rapid treatment of stroke, a leading cause or mortality and morbidity in the United States, or ruling out the ever-growing list of conditions that mimic strokes.
Source: The Journal of Emergency Medicine - October 14, 2021 Category: Emergency Medicine Authors: Vera Obinwanne, Laura Bauler, Dylan Bergeon, Timothy Trichler Source Type: research

Adapting to a New Normal After Severe Acute Brain Injury: An Observational Cohort Using a Sequential Explanatory Design
CONCLUSIONS AND RELEVANCE: Six months after severe acute brain injury, most patients survived to a state their families initially thought would not be acceptable. Survivors and their families need more support and guidance as they adapt to a new normal and struggle with persistent uncertainty.
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Trajectory of Cognitive Decline After Sepsis
OBJECTIVES: Cognitive impairment is an important consequence of sepsis. We sought to determine long-term trajectories of cognitive function after sepsis. DESIGN: Prospective study of the Reasons for Geographic and Racial Differences in Stroke cohort. SETTING: United States. PATIENTS: Twenty-one thousand eight-hundred twenty-three participants greater than or equal to 45 years, mean (sd) age 64.3 (9.2) years at first cognitive assessment, 30.9% men, and 27.1% Black. MEASUREMENTS AND MAIN RESULTS: The main exposure was time-dependent sepsis hospitalization. The primary outcome was global cogni...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Sex differences in outcomes for out-of-hospital cardiac arrest in the United States
Approximately 1,000 out-of-hospital cardiac arrest (OHCA) occur each day in the United States. Although sex differences exist for other cardiovascular conditions such as stroke and acute myocardial infarction, they are less well understood for OHCA. Specifically, the extent to which neurological and survival outcomes after OHCA differ between men and women remains poorly characterized in the U.S.
Source: Resuscitation - March 30, 2021 Category: Emergency Medicine Authors: Pavitra Kotini-Shah, Marina Del Rios, Shaveta Khosla, Oksana Pugach, Kimberly Vellano, Bryan McNally, Terry Vanden Hoek, Paul S. Chan Tags: Clinical paper Source Type: research

Peripheral Nerve Block for Hip Fracture
Acad Emerg Med. 2021 Feb 26. doi: 10.1111/acem.14239. Online ahead of print.ABSTRACTBetween 2000 and 2010, there were 2.6 million hospitalizations for hip fractures in the United States among women over 55 years of age alone.1 This is nearly as many hospitalizations as those for myocardial infarction or stroke among that same population and outnumbered hospitalizations for all other fractures combined.1 Studies have also demonstrated an increased risk for mortality in the months after hip fracture.PMID:33638287 | DOI:10.1111/acem.14239
Source: Accident and Emergency Nursing - February 27, 2021 Category: Emergency Medicine Authors: Michael Gottlieb Brit Long Source Type: research

Healthcare in transition in the Republic of Armenia: the evolution of emergency medical systems and directions forward
AbstractArmenia, an ex-Soviet Republic in transition since independence in 1991, has made remarkable strides in development. The crisis of prioritization that has plagued many post-Soviet republics in transition has meant differential growth in varied sectors in Armenia. Emergency systems is one of the sectors which is neglected in the current drive to modernize. The legacy of the Soviet Semashko system has left a void in specialized care including emergency care. This manuscript is a descriptive overview of the current state of emergency care in Armenia using in-depth key informant interviews and review of published and u...
Source: International Journal of Emergency Medicine - January 12, 2021 Category: Emergency Medicine Source Type: research

Approaches in Prehospital Sepsis Screening
Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have ove...
Source: JEMS Patient Care - January 5, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news

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