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Specialty: Emergency Medicine
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Total 1761 results found since Jan 2013.
Epidemiology of acute kidney injury in patients with stroke: a retrospective analysis from the neurology ICU
AbstractAcute kidney injury (AKI) is proven to be an independent risk factor for adverse clinical outcomes in patients with stroke, but data about the epidemiology of AKI in these patients are not well characterized. Therefore, we investigated the incidence, risk factors, and the impact of AKI on the clinical outcomes in a group of Chinese patients with stroke. We retrospectively recruited 647 stroke patients from the neurology ICU between 2012 and 2013. AKI was identified according to the 2012 KDIGO criteria. Baseline estimated glomerular filtration rate (eGFR) was calculated using modified Chronic Kidney Disease Epidemio...
Source: Internal and Emergency Medicine - June 27, 2017 Category: Emergency Medicine Source Type: research
Acute Stroke: From Prehospital Care to In-Hospital Management
Early recognition of stroke by clinical presentation and prehospital stroke assessment tools facilitate rapid prehospital and ED diagnosis. CanStockPhoto/focalpoint
Stroke is a leading cause of morbidity and mortality in the United States and requires prompt recognition by prehospital providers to ensure rapid transport. Stroke can present in a variety of different ways, some more readily apparent than others.
Delays in diagnosis and treatment can have devastating effects on the outcomes for these patients. In this article, we describe a patient who initially presented with altered mental status and was subsequent...
Source: JEMS Patient Care - May 2, 2018 Category: Emergency Medicine Authors: Henry G. Colmer IV, MD Tags: Patient Care Cardiac & Resuscitation Source Type: news
Treatment Delays for Patients With Acute Ischemic Stroke in an Iranian Emergency Department: A Retrospective Chart Review
ConclusionOur ED and acute stroke team had a favorable clinical performance meeting established critical time goals of inhospital care for potentially eligible patients, but a poor clinical performance for the majority of patients who were not candidates for fibrinolytic therapy.
Source: Annals of Emergency Medicine - October 12, 2018 Category: Emergency Medicine Source Type: research
An Update on Pediatric Stroke Protocol
Pediatric stroke is relatively rare, with approximately 1000 childhood strokes in the United States per year. However, the occurrence of stroke in children leads to significant morbidity and mortality, warranting the development proven screening tools, protocols, and treatment options. Because significant delays in seeking medical attention can occur, time to recognition of pediatric stroke in the emergency department is uniquely challenging and critical. Once recognized, a trained multidisciplinary team with a multifaceted approach is needed to provide the best possible outcome for the patient. Key elements of the pediatr...
Source: Pediatric Emergency Care - November 1, 2018 Category: Emergency Medicine Tags: CME Review Article Source Type: research
Significance of CHA 2 DS 2 -VAS C on the severity and hemorrhagic transformation in patients with non-valvular atrial fibrillation-induced acute ischemic stroke
This study aimed to identify the significance of CHA2DS2-VASC score on the severity and hemorrhagic transformation (HT) in patients with NVAF-induced acute ischemic stroke (NVAF-AIS). Total 113 patients diagnosed as NVAF-AIS were included in this study. Patients were categorized into severe stroke group (NIHSS > 10) and non-severe group (NIHSS ≤ 10), and the risk factors for severe stroke were investigated. Based on the results of repeated brain CT/MRI examination performed within 14 days from stroke onset or immediately in case of clinical worsening, patients were divided into HT group and non-HT group, an...
Source: Internal and Emergency Medicine - January 1, 2021 Category: Emergency Medicine Source Type: research
Effect of Pre-Hospital Workflow Optimization on Treatment Delays and Clinical Outcomes in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.
CONCLUSIONS: This systematic review and meta-analysis found that PSWO significantly improves several time metrics related to stroke treatment leading to improvement in IVT reperfusion rates. Thus, the implementation of these measures in stroke networks is a promising avenue to improve an often-neglected aspect of the stroke response. However, the limited available data suggest functional outcomes and mortality are not significantly improved by PSWO, hence further studies and improvement strategies vis a vis PSWOs are warranted.
PMID: 33387368 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 2, 2021 Category: Emergency Medicine Authors: Chowdhury SZ, Santana Baskar P, Bhaskar S Tags: Acad Emerg Med Source Type: research
Statin treatment and outcomes after embolic stroke of undetermined source
AbstractThe association of low-density lipoprotein cholesterol lowering with outcomes in embolic stroke of undetermined source (ESUS) patients is unclear. In these patients we aimed to assess the effect of statin on stroke recurrence, major adverse cardiovascular events (MACE) and death rates. Consecutive ESUS patients in the Athens Stroke Registry were prospectively followed-up to 10 years for stroke recurrence, MACE, and death. The Nelson–Aalen estimator was used to estimate the cumulative probability by statin allocation at discharge and cox-regression analyses to investigate whether statin at discharge was a predic...
Source: Internal and Emergency Medicine - April 24, 2021 Category: Emergency Medicine Source Type: research
An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings
Conclusions:
Elevated SBP among emergency patients with impaired consciousness in the field was associated with increased diagnosis of stroke.
Source: BMC Emergency Medicine - December 17, 2013 Category: Emergency Medicine Authors: Taro IrisawaTaku IwamiTetsuhisa KitamuraChika NishiyamaTomohiko SakaiKayo Tanigawa-SugiharaSumito HayashidaTatsuya NishiuchiTadahiko ShiozakiOsamu TasakiTakashi KawamuraAtsushi HiraideTakeshi Shimazu Source Type: research
Clearance of serum solutes by hemofiltration in dogs with severe heat stroke
Background:
We have previously reported that hemofiltration (HF) may be an effective additional means of treating heat stroke when rapid cooling is not effective.
Methods:
Dogs were assigned to a heat stroke (control) or heat stroke?+?hemofiltration (HF) group (n?=?8 each group). After heat stroke induction, dogs in the HF group received HF for 3?h. Serum concentrations of interleukin (IL)-10, tumor necrosis factor (TNF)-?, IL-6, blood urea nitrogen (BUN) and creatinine were measured at baseline and 1, 2, and 3?h after heat stroke. Clearance rates of solutes were determined 1, 2, and 3?h after the start of HF.
Results:
Ser...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - August 22, 2014 Category: Emergency Medicine Authors: Guang-Ming ChenYu-Ying LanCheng-Feng WangHai-Xia ZhanWen-Rui WangJin-Hua ChenJian Chen Source Type: research
The Association Between Emergency Department Crowding and the Disposition of Patients With Transient Ischemic Attack or Minor Stroke
ConclusionsThese results suggest that crowding may influence clinical decision‐making in the disposition of patients with TIA or minor stroke and that, as crowding worsens, the likelihood of hospitalization increases.
Source: Academic Emergency Medicine - September 1, 2015 Category: Emergency Medicine Authors: Maxim Ben‐Yakov, Moira K. Kapral, Jiming Fang, Shudong Li, Marian J. Vermeulen, Michael J. Schull Tags: Original Contribution Source Type: research
Stroke and Helicopter Emergency Medical Service Transports: An Analysis of 25,332 Patients
Conclusions HEMS has increased access to stroke care for super-rural, rural, and urban communities offering timely transport within the treatment window if symptoms are recognized within 2.5 hours of onset. This study created a methodology for future multicenter aggregate data studies.
Source: Air Medical Journal - November 24, 2015 Category: Emergency Medicine Source Type: research
Agreement between ambulance and hospital records for information promoting urgent stroke treatment decisions
Conclusion: In a retrospective cohort of stroke patients admitted by emergency ambulance, standard practice did not consistently result in prehospital documentation of information that could promote rapid treatment decisions. Training emergency practitioners and/or providing clinical protocols could facilitate early stroke treatment decisions, but prehospital information availability is likely to be a limiting factor.
Source: European Journal of Emergency Medicine - December 21, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research
Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine
ConclusionsGiven the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund the up‐front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care.
Source: Academic Emergency Medicine - December 31, 2015 Category: Emergency Medicine Authors: Elham Torabi, Craig M. Froehle, Christopher J. Lindsell, Charles J. Moomaw, Daniel Kanter, Dawn Kleindorfer, Opeolu Adeoye Tags: Original Contribution Source Type: research
Study Shows Race and Sex Disparities in Prehospital Stroke Recognition
In this study, Govindarajan, from the University of California, San Francisco, led a diverse team of researchers comparing hospital discharge diagnosis to field impressions documented in EMS electronic charts from two California counties.
The team used probabilistic linking to retrospectively associate EMS and hospital database records. They analyzed records from 14 hospitals in these two counties from 2005– 2007, and identified 10,719 stroke patients.
Retrospective "data-mining" practices with large databases pose serious threats to the validity of a study. In this case however, researchers did a gre...
Source: JEMS Patient Care - September 8, 2015 Category: Emergency Medicine Authors: David Page, MS, NRP Tags: Special Topics Cardiac & Resuscitation Research Columns Patient Care Source Type: news
