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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
Investigation of UCH-L1 levels in ischemic stroke, intracranial hemorrhage and metabolic disorder induced impaired consciousness
We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.
Source: The American Journal of Emergency Medicine - June 21, 2017 Category: Emergency Medicine Authors: Ihsan Yigit, Metin Atescelik, Mustafa Yilmaz, Mehmet Cagri Goktekin, Mehtap Gurger, Nevin Ilhan Source Type: research
Bi-objective approach for placing ground and air ambulance base and helipad locations in order to optimize EMS response
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster.
Source: The American Journal of Emergency Medicine - June 15, 2017 Category: Emergency Medicine Authors: Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi Source Type: research
Can we imagine a survival chain also for ischemic stroke?
I read with great interest the article about the University of Amiens experience in the management of acute stroke [1] and the concept of “door-to-needle” time, so similar to the best known “door-to-balloon” one. During my recent training period in an excellent Stroke Unit, I've directly experienced a quite brand new concept, brought by mechanical thrombectomy, the “door-to-reperfusion” time. We know from meta-analysis dat a that for every 9-minute delay in reperfusion, 1 of every 100 treated patients had a worse disability outcome (+1 point on MrS scale) [2].
Source: The American Journal of Emergency Medicine - May 29, 2017 Category: Emergency Medicine Authors: Aurora Vecchiato Source Type: research
An educational intervention allows for greater prehospital recognition of acute stroke
We performed a study to determine whether a brief educational intervention directed at pre-hospital providers would increase the identification of stroke victims in the pre-hospital setting. The purpose of this IRB approved, before-and-after research project was to determine whether the implementation of Advanced Stroke Life Support Class (ASLS) [1] training for pre-hospital providers would lead to improved field identification of stroke.
Source: The American Journal of Emergency Medicine - May 23, 2017 Category: Emergency Medicine Authors: Tara K. Henry-Morrow, Bryan D. Nelson, Erin Conahan, Claranne Mathiesen, Bernadette Glenn-Porter, Matthew T. Niehaus, Lauren M. Porter, Mitchell R. Gesell, Gregory T. Monaghan, Jeanne L. Jacoby Tags: Correspondence Source Type: research
The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research
Alterations in optic nerve sheath diameter according to cerebrovascular disease sub-groups
ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed.
Source: The American Journal of Emergency Medicine - April 29, 2017 Category: Emergency Medicine Authors: Emre G ökcen, İbrahim Caltekin, Atakan Savrun, Hilal Korkmaz, Şeyda Tuba Savrun, Gökhan Yıldırım Source Type: research
Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke
The objective of the current study was to assess whether HbA1c-based adjusted glycemic variables were associated with unfavorable outcomes among patients admitted to the hospital for AIS.
Source: The American Journal of Emergency Medicine - March 21, 2017 Category: Emergency Medicine Authors: Chih-Jen Yang, Wen-I Liao, Jen-Chun Wang, Chia-Lin Tsai, Jiunn-Tay Lee, Giia-Sheun Peng, Chien-Hsing Lee, Chin-Wang Hsu, Shih-Hung Tsai Source Type: research
Regional disparities in the quality of stroke care
This study characterized geographic disparities in stroke care quality to assess whether improved access to neurological services has the potential to bridge the care quality gap, particularly in terms of alteplase (rt-PA) administration.
Source: The American Journal of Emergency Medicine - March 18, 2017 Category: Emergency Medicine Authors: Seth Seabury, Katalin Bognar, Yaping Xu, Caroline Huber, S. Renee Commerford, Darren Tayama Source Type: research
Effect of paracetamol (acetaminophen) on body temperature in acute stroke: A meta-analysis
The objective of this study was to assess the efficacy of paracetamol (acetaminophen) on body temperature in acute stroke.
Source: The American Journal of Emergency Medicine - March 17, 2017 Category: Emergency Medicine Authors: Junjie Fan, Chensong Cheng, Hongsen Cheng, Ren Wang, Linhao Ma Source Type: research
Simple and effective method to lower body core temperatures of hyperthermic patients
Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]).
Source: The American Journal of Emergency Medicine - January 29, 2017 Category: Emergency Medicine Authors: John P. O'Connor Source Type: research
Cardiac Direct Access Centers and the Mission of Emergency Medicine
In the past 60 years, rigorous emphasis on rapid diagnosis, evidence-based treatment, team dynamics and targeted resuscitation of critically ill and injured patients has led to dramatic improvements in emergency department patient outcomes including mortality [1,2]. This is especially true in severely injured trauma patients, those suffering from ST-elevation myocardial infarctions (STEMI), sepsis and stroke [3-5]. In an effort to distinguish themselves as providers of sophisticated specialty and general emergency care, many organizations and departments seek designations as “centers of excellence,” such as the America...
Source: The American Journal of Emergency Medicine - January 18, 2017 Category: Emergency Medicine Authors: Emily Brumfield, Corey Slovis Source Type: research
Creation of an intensive care unit and organizational changes in an adult emergency department: impact on acute stroke management
Following the reorganization of a University Medical Center onto a single campus, an Intensive Care Unit was created within the adult Emergency Department (ED ICU). We assessed the effects of these organizational changes on acute stroke management and the intravenous administration of recombinant tissue plasminogen activator (IV rtPA), as characterized by the thrombolysis rate, door-to-needle time (DNT) and outcome at 3 months.
Source: The American Journal of Emergency Medicine - January 8, 2017 Category: Emergency Medicine Authors: Laurent Puy, Chantal Lamy, Sandrine Canaple, Audrey Arnoux, Nicolas Laine, Ella Iacob, Jean-Marc Constans, Olivier Godefroy Source Type: research
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
Neutrophil to lymphocyte ratio and the hematoma volume and stroke severity in acute intracerebral hemorrhage patients
Neutrophil to lymphocyte ratio (NLR) serves as a powerful inflammatory marker for predicting cardiovascular events. Here, we investigate whether admission NLR is associated with hematoma volume, stroke severity, and 3-month outcomes in patients with acute intracerebral hemorrhage (ICH).
Source: The American Journal of Emergency Medicine - November 15, 2016 Category: Emergency Medicine Authors: Yaming Sun, Shoujiang You, Chongke Zhong, Zhichao Huang, Lifang Hu, Xia Zhang, Jijun Shi, Yongjun Cao, Chun-Feng Liu Source Type: research
Utility of point of care assessment of platelet reactivity (using the PFA-100 ®) to aid in diagnosis of stroke
Rapid and accurate diagnosis of patients presenting with symptoms of stroke is needed to facilitate the timely delivery of proven effective treatment for patients with acute ischemic stroke (AIS).The aim of this study was to determine whether early assessment of platelet reactivity in patients presenting with symptoms of AIS was associated with a diagnosis of AIS, transient ischemic attack (TIA), or stroke mimic.
Source: The American Journal of Emergency Medicine - November 14, 2016 Category: Emergency Medicine Authors: Claire Pearson, Karin Przklenk, Valerie Mika, Syed Imran Ayaz, Morgan Ellis, Preet Varade, Rosa Tolomello, Robert D. Welch Source Type: research
