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Specialty: Emergency Medicine

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Total 1761 results found since Jan 2013.

A radiologist ’s guide to the clinical scales used in the 2015 Endovascular Stroke Trials and the Revised American Heart Association/American Stroke Association Guidelines for Endovascular Stroke Treatment
Abstract In 2015, five trials demonstrated the efficacy of endovascular treatment for acute stroke, culminating in the revised American Heart Association/American Stroke Association (AHA/ASA) recommendations for stroke management. The different clinical scales used in these trials may be unfamiliar to emergency and on-call radiologists. The modified Rankin Scale was used to describe patient disability for prestroke assessment in three of the trials and for the 90-day follow up in all five trials. The Barthel index was used in one trial to score prestroke ability to perform activities of daily living. The NIH Stroke Scale ...
Source: Emergency Radiology - July 6, 2016 Category: Emergency Medicine Source Type: research

Mobile Stroke Units: A Device in Search of an Indication
If you've been to any regional or national EMS conference in the last two years, you've seen these mobile stroke units. They are beautiful large ambulances with the latest and greatest in modern technology including mobile CT scanners. Often, the name of a hospital is blazoned on the side. There is usually a staff member present to tell you how great these will be for your community. But are they? Where's the science? What's the cost? These are important questions that should be asked and answered before these devices are deployed on a widespread basis. Although still somewhat controversial, therapies are now available to ...
Source: JEMS Patient Care - January 12, 2017 Category: Emergency Medicine Authors: Bryan Bledsoe, DO, FACEP, FAEMS Tags: Patient Care Source Type: news

Transcranial Doppler Microemboli Monitoring for Stroke Risk Stratification in Blunt Cerebrovascular Injury
Conclusions: Microemboli burden is associated with higher risk of stroke due to internal carotid artery injuries, but monitoring was not useful for vertebral artery injuries.
Source: Critical Care Medicine - September 16, 2017 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Racial Differences in Palliative Care Use After Stroke in Majority-White, Minority-Serving, and Racially Integrated U.S. Hospitals
Conclusions: The odds of receiving palliative care for both white and minority stroke patients is lower in minority compared with white hospitals, suggesting system-level factors as a major contributor to explain race disparities in palliative care use after stroke.
Source: Critical Care Medicine - November 18, 2017 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

The Relationship Between Ambient Air Pollution and Acute Ischemic Stroke: A Time-Stratified Case-Crossover Study in a City-State With Seasonal Exposure to the Southeast Asian Haze Problem
ConclusionWe found a short-term elevated risk of ischemic stroke after exposure to air pollution. These findings have public health implications for stroke prevention and emergency health services delivery.
Source: Annals of Emergency Medicine - August 30, 2018 Category: Emergency Medicine Source Type: research

Current Methods for the Prehospital Detection of Large Vessel Occlusion (LVO) Ischemic Stroke
AbstractPurpose of ReviewThis review describes the technologies and methods currently utilized to detect large vessel occlusion (LVO) ischemic stroke in the prehospital setting. A comparison of various LVO stroke scales, including their similarities and differences, is included. Emerging technology, novel stroke detection methods, and likely areas of future research are discussed.Recent FindingsMany prehospital stroke detection scales have been described previously in the medical literature, characterized by varying degrees of efficacy. Despite their cost-effectiveness and ease of use, prehospital stroke scales do not reli...
Source: Current Emergency and Hospital Medicine Reports - January 11, 2021 Category: Emergency Medicine Source Type: research

Benefits and safety of transdermal glyceryl trinitrate in acute stroke: a systematic review and meta-analysis of randomised trials
CONCLUSIONS: Transdermal GTN reduces BP in acute stroke but does not alter clinical outcomes even in ultra-early stroke (≤ 6 hours).PMID:34741770 | DOI:10.1111/acem.14408
Source: Accident and Emergency Nursing - November 6, 2021 Category: Emergency Medicine Authors: Beng Leong Lim Wei Feng Lee Wei Ming Ng Wangmin Situ Kee Vooi Loo Jia Man Carmen Goh Wui Ling Chan Source Type: research

Predictive value of the Cincinnati Prehospital Stroke Scale for identifying thrombolytic candidates in acute ischemic stroke
Abstract: Background: Despite the usefulness of the Cincinnati Prehospital Stroke Scale (CPSS) for rapid recognition of acute stroke, its ability to assess stroke severity is unclear. We investigated the usefulness of CPSS for assessment of stroke severity by comparing CPSS and National Institutes of Health Stroke Scale (NIHSS) scores in patients who were candidates for thrombolytic therapy at hospital admission within 6 hours of symptom onset.Methods: We conducted a retrospective analysis of a prospective registry database of consecutive patients included in the brain salvage through emergency stroke therapy program. In t...
Source: The American Journal of Emergency Medicine - September 23, 2013 Category: Emergency Medicine Authors: Je Sung You, Sung Phil Chung, Hyun Soo Chung, Hye Sun Lee, Jong Woo Park, Hyun Jong Kim, Shin Ho Lee, Incheol Park, Hahn Shick Lee Tags: Brief Reports Source Type: research

Stroke: prospective evaluation of a prehospital management process based on rescuers under medical direction
Abstract: Background: Improving access to thrombolytic therapy for patients with ischemic stroke is challenging. We assessed a prehospital process based on firemen rescuers under strict medical direction, aimed at facilitating thrombolysis of eligible patients.Methods: This was a prospective observational study conducted over 4 months in Paris, France. Prehospital patients with suspected stroke were included after telephone consultation with a physician. If the time since the onset of symptoms was less than 6 hours, patients were transported directly to a neurovascular unit (NVU); if symptom onset was more than 6 hours ago...
Source: The American Journal of Emergency Medicine - February 3, 2014 Category: Emergency Medicine Authors: Laure Alhanati, Stéphane Dubourdieu, Clément Hoffmann, Francis Béguec, Stéphane Travers, Hugues Lefort, Olga Maurin, Daniel Jost, Laurent Domanski, Jean-Pierre Tourtier Tags: Original Contributions Source Type: research

Race and Sex Disparities in Prehospital Recognition of Acute Stroke.
CONCLUSIONS: Significant disparities exist in prehospital stroke recognition. PMID: 25728356 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - February 25, 2015 Category: Emergency Medicine Authors: Govindarajan P, Friedman BT, Delgadillo JQ, Ghilarducci D, Cook LJ, Grimes B, McCulloch CE, Johnston SC Tags: Acad Emerg Med Source Type: research

Validation of ABCD2 scores ascertained by referring clinicians: a retrospective transient ischaemic attack clinic cohort study
Conclusions ABCD2 scores recorded by referring clinicians did not identify patients at high risk of subsequent stroke, suggesting that the score should not be used for TIA clinic triage.
Source: Emergency Medicine Journal - July 19, 2016 Category: Emergency Medicine Authors: Dutta, D., Bailey, S.-J. Tags: Stroke Original article Source Type: research

Paramedic acute stroke treatment assessment (pasta) trial
This study is evaluating whether an enhanced assessment by paramedics could speed up treatment and improve stroke recovery. Method Study design Multicentre cluster randomised trial with cost-effectiveness analysis and parallel process evaluation. Setting NHS ambulance services, emergency departments and stroke units within three geographical regions of England and Wales. Study intervention A Paramedic Acute Stroke Treatment Assessment (PASTA) pathway initiated by paramedics and continued initially in hospital to facilitate the speed of brain imaging and delivery of thrombolysis when clinically appropriate. Study cont...
Source: Emergency Medicine Journal - August 17, 2016 Category: Emergency Medicine Authors: Shaw, L., Ford, G. A., Exley, C., Flynn, D., McMeekin, P., Rodgers, H., Snooks, H., Tyrell, P., Vale, L., Price, C. Tags: Poster Presentations Source Type: research

Validation of the cincinnati prehospital stroke scale
Conclusion: As a prehospital screening tool, CPSS can be extremely useful as any diagnosis is only provisional until confirmed by an appropriate investigation in a hospital.
Source: Journal of Emergencies, Trauma and Shock - May 29, 2018 Category: Emergency Medicine Authors: Aditya Maddali Farook Abdul Razack Srihari Cattamanchi Trichur V Ramakrishnan Source Type: research

The frequency, characteristics and aetiology of stroke mimic presentations: a narrative review
A significant proportion of patients with acute stroke symptoms have an alternative ‘mimic’ diagnosis. A narrative review was carried out to explore the frequency, characteristics and aetiology of stroke mimics. Prehospital and thrombolysis-treated patients were described separately. Overall, 9972 studies were identified from the initial search and 79 studies were included with a median stroke mimic rate of 19% (range: 1–64%). The prehospital median was 27% (range: 4–43%) and the thrombolysis median 10% (range: 1–25%). Seizures, migraines and psychiatric disorders are the most frequently reported causes of stroke...
Source: European Journal of Emergency Medicine - December 19, 2018 Category: Emergency Medicine Tags: REVIEW ARTICLES Source Type: research