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Specialty: Emergency Medicine

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Total 1761 results found since Jan 2013.

Inhalation of 2% Hydrogen Improves Survival Rate and Attenuates Shedding of Vascular Endothelial Glycocalyx in Rats with Heat Stroke
Heat stroke is characterized by excessive oxidative stress and inflammatory responses, both of which are implicated in vascular endothelial glycocalyx shedding and heat-stroke mortality. Although molecular hydrogen has antioxidation and anti-inflammatory potency, its effect on the vascular endothelial glycocalyx in heat stroke has not been examined. Therefore, the aim of this study was to investigate the influence of hydrogen inhalation on the survival and thickness of the vascular endothelial glycocalyx of rats subjected to heat stroke. Altogether, 98 Wistar rats were assigned to the experiments. A heat-controlled chamber...
Source: Shock - September 23, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Comparing Emergency Medical Services Processing Times for Stroke Patients Before and During COVID-19 Pandemic; A Cross-sectional Study
CONCLUSIONS: During COVID-19 pandemic, the number of acute stroke patients serviced by EMS increased substantially, but there was no difference in the average number of patients per week. During the pandemic, EMS processing times markedly increased.PMID:36381971 | PMC:PMC9637259 | DOI:10.22037/aaem.v10i1.1710
Source: Accident and Emergency Nursing - November 16, 2022 Category: Emergency Medicine Authors: Thongpitak Huabbangyang Rossakorn Klaiangthong Krit Prasittichok Sutida Koikhunthod Jakkapan Wanna Nutthapong Sudajun Parichat Khaisri Anucha Kamsom Source Type: research

Four Evolving Strategies In The Emergent Treatment Of Acute Ischemic Stroke (Stroke CME)
This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care.
Source: Emergency Medicine Practice - July 2, 2012 Category: Emergency Medicine Source Type: research

Systemic thrombolysis for stroke in pregnancy
Pregnancy is an exclusion criterion for all clinical trials that validate alteplase in acute stroke, so our knowledge about its use in this condition is relative only to case reports and case series. Herein, we report the successful use of intravenous recombinant tissue-type plasminogen activator (rt-PA) in pregnant women with acute stroke. The patient was a 28-year-old who was 16 weeks pregnant. She presented to our hospital 1 hour after a sudden onset of mothor aphasia, hemiparesis, and hypoesthesia on the right side due to incipient ischemia in the left cerebral hemisphere resulting from ipsilateral middle cerebral arte...
Source: The American Journal of Emergency Medicine - August 6, 2012 Category: Emergency Medicine Authors: Rossana Tassi, Maurizio Acampa, Giovanna Marotta, Samuele Cioni, Francesca Guideri, Simone Rossi, Alfonso Cerase, Giuseppe Martini Tags: Case Reports Source Type: research

Community implementation of intravenous thrombolysis for acute ischemic stroke in the 3- to 4.5-hour window
Discussion: Our results show that the conclusions of the ECASS III trial can be applied to routine stroke treatment at a community center and that IV thrombolysis in the 3- to 4.5-hour window results in similar safety and efficacy functional outcome at 3 months compared with administration before 3 hours after onset.
Source: The American Journal of Emergency Medicine - September 23, 2013 Category: Emergency Medicine Authors: Arturo Montaño, Ilene Staff, Louise D. McCullough, Gil Fortunato Tags: Brief Reports Source Type: research

Stroke Code. Intravenous Thrombolysis in Ischemic Stroke. Experience and Results
To analyze the performance and clinical outcomes of the implementation of a stroke code protocol in our field. Descriptive, observational study of all patients treated with intravenous thrombolysis with alteplase (rt-PA) over a 5-year period and analysis of the stroke code circuit performance, response time, clinical, neurological (National Institutes of Health Stroke Scale [NIHSS]), and functional status (modified Rankin scale [mRS]) after treatment and 3 months later.
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: D.R. Seguí, A.M. Destruels, J.G. Mora, M.C.B. Oliva, A.P. Guinjoan, F.X. Avilés Jurado, X. Ustrell Source Type: research

Impact of Emergency Medical Service System on Fibrinolysis among Patients with Ischemic Stroke in the Northern French Alps
Stroke represents the leading cause of functional impairment and the third cause of mortality in developed countries. Since the use of fibrinolytic therapy (FT), prehospital time from first clinical symtoms to FT in a stroke unit is challenging our health care system. When emergency medical services (EMS) is called, recognition of stroke and rapid transportation to appropriate facilities could lead to an increase in the frequency of FT and improved outcome. The aim of the study was to assess prehospital times and FT for patients with ischemic stroke managed by the EMS system, compared to self-attending patients in the emer...
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: C. Vallot, C. Ricard, C. Tinchant, O. Detante, F. Loizzo, S. Marcel, T. Roupioz, W. Vadot, Loic Belle, Francois-Xavier Ageron Source Type: research

The Relation between Plasma Gelsolin Levels and Prognosis in Patients with Acute İschemic Stroke upon Admission to Emergency Department
To compare serum gelsolin levels and Glasgow Coma Scale (GCS) scores in patients with acute ischemic stroke and to compare with healthy control subjects. Included in this study were patients with onset of symptoms in the first 3 h after acute ischemic stroke. Healthy volunteers were included as the control group. Patients with chronic obstructive pulmonary disease, diabetes mellitus, acute coronary syndromes, renal failure, heart failure, trauma, hepatic failure, infection, sepsis, and hematologic and oncologic disease were excluded from study. Venous blood samples were obtained from the patients and the control group upo...
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: A. Bayir, N. Tufekci, H. Vatansev, H. Baran, H. Kara, S.A. Kayis 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

Implementing Diagnostic Reasoning to Differentiate Todd's Paralysis From Acute Ischemic Stroke
Emergency department clinicians with limited resources are relied upon to deliver safe and timely patient care. Clinicians rely on cognitive biases such as anchoring, availability, and premature closure based on experience and quick mental algorithms to streamline medical data and arrive at a diagnosis. Although this is a time-saving and efficient method in the management of uncomplicated illnesses, it can result in a wrong diagnosis when managing patients with complicated presentations such as a stroke or a stroke mimic. Two conditions that present similarly, making it difficult to differentiate between them, are Todd's p...
Source: Advanced Emergency Nursing Journal - January 1, 2014 Category: Emergency Medicine Tags: Cases of Note Source Type: research

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

Evaluation of pre-hospital transport time of stroke patients to thrombolytic treatment
Background: Effective treatment of stroke is time dependent. Pre-hospital management is an important link in reducing the time from occurrence of stroke symptoms to effective treatment. The aim of this study was to evaluate time used by emergency medical services (EMS) for stroke patients during a five-year period in order to identify potential delays and evaluate the reorganization of EMS in Copenhagen in 2009. Methods: We performed a retrospective analysis of ambulance records from stroke patients suitable for thrombolysis from 1 January 2006 to 7 July 2011. We noted response time from dispatch of the ambulance to arriva...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - November 13, 2014 Category: Emergency Medicine Authors: Sofie SimonsenMorten AndresenLene MichelsenSøren ViereckFreddy LippertHelle Iversen Source Type: research

Are the current MRI criteria using the DWI-FLAIR mismatch concept for selection of patients with wake-up stroke to thrombolysis excluding too many patients?
Conclusions: In this small series DWI-FLAIR mismatch was not associated with worse outcome or ICH. This suggests that selecting WUS patients using DWI-FLAIR mismatch in clinical trials may exclude a large group of patients who might benefit.
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - February 19, 2015 Category: Emergency Medicine Authors: Audun OdlandPål SærvollRajiv AdvaniMartin KurzKathinka Kurz Source Type: research