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Specialty: Emergency Medicine
Condition: Pain

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Total 103 results found since Jan 2013.

Simultaneous event of brachial artery occlusion and acute embolic stroke
Although the rapid and accurate diagnosis of both acute ischemic stroke and extremity ischemia is essential to the timely and appropriate treatment, it is not always easy to differentiate between true stroke and stroke mimics. Although in general, limb ischemia due to extremity embolism is not included in stroke mimics or misdiagnosis, limb arterial embolism should be considered in the differential diagnosis of acute monoparesis because the diagnosis may be missed if the other typical manifestations of this presentation (pain, pallor, pulselessness, sensory loss, and coolness of the arm) are overlooked.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Soo Hoon Lee, Nack-Cheon Choi, In Seok Jang, Tae-Sin Kang, Changwoo Kang, Jin Hee Jeong, Dong Seob Kim Tags: Case Report Source Type: research

Ischemic Stroke Differential Diagnose: Spontaneous Spinal Epidural Hematoma can be fatal
Spontaneous Spinal Epidural Hematoma (SSEH) is rarely seen, it is the important reason for the spinal cord compression. Patients generally visit the doctor due to the acute pain in the neck and interscapular area. The male patient 58years old was admitted to the emergency service of our hospital with the sudden onset neck pain and followed by rapidly right hemiparesis He arrived at our hospital 120minutes after the onset of her symptoms with suspected acute stroke. We assessed for acute stroke performed clinical examinations necessary for intravenous thrombolytic treatment with alteplase, No abnormality was observed in his...
Source: The American Journal of Emergency Medicine - January 21, 2015 Category: Emergency Medicine Authors: Huseyin Buyukgol, M. Kemal Ilik, Faik Ilik Source Type: research

Stroke-like manifestation of a spontaneous spinal epidural hematoma with spontaneous resolution: a case report
ConclusionsSEH, although uncommon, can be a mimic of stroke and it is important to avoid misdiagnosis as it is a time critical diagnosis, and administration of thrombolysis or antiplatelets can lead to unfavourable outcomes. Having a high clinical suspicion can help to guide us in the choice of imaging and interpretation of subtle signs to reach the correct diagnosis in a timely manner. Further research is required to better understand the factors that would favour a conservative approach as opposed to surgical treatment.
Source: International Journal of Emergency Medicine - February 20, 2023 Category: Emergency Medicine Source Type: research

Benedictine hand of 'central' origin
A 67-year-old man was admitted to emergency room to investigate a left hand weakness started on awakening. Anamnesis revealed only a mild hypertension currently treated with ACE-inhibitors. Antigravitary tests in upper limbs showed a ‘benedictine’ hand (figure 1A,B). Sensory examination was unremarkable although the patient complained of nocturnal paraesthesias in left hand. Brain CT scan was negative. Initial diagnosis was ischaemic stroke even if a proximal median nerve injury was mimicked. Nerve conduction study and electromyographic examination of left arm, performed the day after, showed only a ‘mild...
Source: Emergency Medicine Journal - January 24, 2013 Category: Emergency Medicine Authors: Luigetti, M., Ranieri, F., Profice, P., Pilato, F., Capone, F., Di Lazzaro, V. Tags: Workplace injury, Pain (neurology), Stroke, Hypertension, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

The locked-in syndrome: posterior stroke in the ED
We present this report and brief review as it is unusual to watch locked-in syndrome evolve in the ED. Providers should be aware of the presenting symptoms and the differential diagnosis for bulbar muscle weakness as well as the management of posterior stroke.
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Corey Goldberg, Stephen Topp, Christopher Hopkins Tags: Case Reports Source Type: research

Acute neurology in the emergency department
A 66-year-old woman presented with sudden onset tearing interscapular pain 1 h after gentle neck exercises. Over the next 3 h, she developed flaccid left arm and leg paralysis and a left Horner's syndrome. Her initial CT scan revealed no evidence of cerebral ischaemia or aortic/carotid dissection but did reveal what was thought to be a calcified arteriovenous malformation in the right frontal lobe. Thrombolysis for a presumed acute stroke was considered but not initiated. By 5 h, the patient had lost light touch sensation and proprioception of her left side, and additionally she developed grade 3/5 right-sid...
Source: Emergency Medicine Journal - December 22, 2013 Category: Emergency Medicine Authors: Mertes, S. C. Tags: Eye Diseases, Spinal cord injury, Pain (neurology), Spinal cord, Stroke, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

The utility of copeptin in the emergency department as a predictor of adverse outcomes in non-ST-elevation acute coronary syndrome: the COPED-PAO study
Conclusions In patients with NSTEACS, determination of copeptin at presentation to the ED is associated with risk of death during the subsequent month. This association, however, disappears after adjusting by baseline features or troponin level, so copeptin does not add complementary prognostic information over that provided by troponin.
Source: Emergency Medicine Journal - March 12, 2014 Category: Emergency Medicine Authors: Sanchez, M., Llorens, P., Herrero, P., Martin-Sanchez, F. J., Pinera, P., Miro, O., on behalf of COPEP study investigators, Alvarez-Medina, Pavon Monzo, Perez Dura, Valles Tarazona, Garcia, Poblador, Castro, Jimenez, Lopez, Morales, del Castillo, Artacho, Tags: Drugs: cardiovascular system, Pain (neurology), Stroke Original article Source Type: research

ESO Launches 2018 ESO EMS Index to Track Nationwide EMS Performance Across Five Metrics
AUSTIN, Texas – ESO Solutions, Inc., the leading data and software company serving emergency medical services (EMS), hospitals and fire departments, today announced the findings of its inaugural report, the 2018 ESO EMS Index. The Index tracks performance of EMS agencies nationwide across five metrics: Stroke assessment and documentation, overdose events, end-tidal carbon dioxide (ETCO2) monitoring, 12-lead electrocardiogram (EKG) use and aspirin administration for chest pain. Data used for the Index are from January 1, 2017 through December 31, 2017. “There are changes on the horizon for EMS agencies across the countr...
Source: JEMS: Journal of Emergency Medical Services News - February 15, 2018 Category: Emergency Medicine Authors: ESO Solutions Tags: Industry News Source Type: news

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

Ditch the Machine to Improve Accuracy in Blood Pressure Measurement and Diagnostics
Conclusion For the patient in this case, the decision to forego the convenience of a machine in favor of the skills of a knowledgeable paramedic was lifesaving. Much like the comparison often drawn between the old-fashioned barbell and more sophisticated exercise machines, newer, more complex, and more expensive might make a process more comfortable, but doesn’t always equate to superior results. As we surrender more and more of our hands-on skills to the ease of automated technology, we risk more than the loss of the aptitudes that form the foundation of sound patient assessment—we place our patients in jeopardy of mi...
Source: JEMS Special Topics - October 24, 2018 Category: Emergency Medicine Authors: Mark Rock, NRP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

The Case Files: Traumatic Carotid Dissection
By Hsiao, Jonie MD   A 30-year-old man who was right-hand dominant presented 10 days after sustaining left-sided face and head trauma from a fall from a skateboard at an unknown speed. He lost consciousness for several seconds, and initially developed a headache with nausea and vomiting. A non-contrast head CT performed at another hospital done two days after the incident was reportedly negative.   He now presents primarily with concerns about the appearance of his left eye. He has notable anisocoria and a droopy eyelid. His left pupil is notably smaller, 2 mm, compared with the right eye, 5 mm. Both are reactive. The re...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

European Resuscitation Council Guidelines 2021: First aid
The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, manage...
Source: Resuscitation - March 24, 2021 Category: Emergency Medicine Authors: David A. Zideman, Eunice M. Singletary, Vere Borra, Pascal Cassan, Carmen D. Cimpoesu, Emmy De Buck, Therese Dj ärv, Anthony J. Handley, Barry Klaassen, Daniel Meyran, Emily Oliver, Kurtis Poole Source Type: research

Clinical Factors and Expenditures Associated With ICD ‐9‐CM Coded Trauma for the US Population: A Nationally Representative Study
ConclusionsTrauma results in a significant health care expenditure burden, both per person and on the US population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis and asthma are more likely to have trauma, and that differences exist in expenditures for office‐based, outpatient, dental and the ER.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - December 14, 2016 Category: Emergency Medicine Authors: Clara E. Dismuke, Kinfe G. Bishu, Samir Fakhry, Rebekah J. Walker, Leonard E. Egede Tags: Original Contribution Source Type: research

Clinical Factors and Expenditures Associated With ICD-9-CM Coded Trauma for the US Population: A Nationally Representative Study.
CONCLUSIONS: Trauma results in a significant health care expenditure burden, both per person and on the US population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis and asthma are more likely to have trauma, and that differences exist in expenditures for office-based, outpatient, dental and the ER. This article is protected by copyright. All rights reserved. PMID: 27976494 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - December 14, 2016 Category: Emergency Medicine Authors: Dismuke CE, Bishu KG, Fakhry S, Walker RJ, Egede LE Tags: Acad Emerg Med Source Type: research