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Specialty: Emergency Medicine

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Total 1761 results found since Jan 2013.

A Shorter Door-In-Door-Out Time Is Associated with Improved Outcome in Large Vessel Occlusion Stroke
We examined the association between DIDO times and 90-day outcomes as measured by the modi fied Rankin scale.Results: A total of 435 patients were included in the final analysis. The mean DIDO time for patients with good outcomes was 17 minute shorter than patients with poor outcomes (122 minutes [min] vs 139 min, P = 0.04)....
Source: Western Journal of Emergency Medicine - August 30, 2023 Category: Emergency Medicine Authors: Sigal, Adam Source Type: research

Racial Differences in Triage for Emergency Department Patients with Subjective Chief Complaints
In this study we aimed to determine whether these effects are more pronounced for patients with subjective complaints.Methods: We performed a retrospective analysis for all adult visits between 2016-2019 at an urban academic emergency department (ED) with acuity-based pods. We determined rates of initial high-acuity triage both across all patients and among the subset located in the high-acuity pod at time of disposition (either through initial assignment or subsequent up-triage). Analysis was performed for common chief complaints categorized as subjective (chest pain, dyspnea, any pain); observed (altered mental status); ...
Source: Western Journal of Emergency Medicine - August 30, 2023 Category: Emergency Medicine Authors: Peitzman, Cassandra Source Type: research

Simultaneous cardiocerebral infarction associated with postcoital activity
Cardiocerebral infarction (CCI) is a rare and life-threatening presentation of simultaneous acute myocardial infarction and acute ischemic stroke that requires prompt recognition and proper treatment. CCI is time sensitive and carries a high mortality rate. There is no standardized treatment algorithm that addresses both conditions simultaneously.
Source: The Journal of Emergency Medicine - August 25, 2023 Category: Emergency Medicine Authors: Carl Pastore, Michael White, Michael Henry, Levi Filler Tags: Clinical Communications: Adults Source Type: research

Recognition of visual symptoms in stroke: a challenge to patients, bystanders, and Emergency Medical Services
Identification of visual symptoms as a sign of acute stroke can be challenging for both first line healthcare professionals and lay persons. Failed recognition of visual symptoms by medical dispatchers at the ...
Source: BMC Emergency Medicine - August 25, 2023 Category: Emergency Medicine Authors: Kristina Parsberg Berg, Viktor Frederik Idin S ørensen, Stig Nikolaj Fasmer Blomberg, Helle Collatz Christensen and Christina Kruuse Tags: Research Source Type: research

Simultaneous cardiocerebral infarction associated with post-coital activity
Cardiocerebral infarction (CCI) is a rare and life-threatening presentation of simultaneous acute myocardial infarction (AMI) and acute ischemic stroke (AIS) that requires prompt recognition and proper treatment. CCI is time sensitive and carries a high mortality rate. There is no standardized treatment algorithm that addresses both conditions simultaneously.
Source: The Journal of Emergency Medicine - August 25, 2023 Category: Emergency Medicine Authors: Carl Pastore, Michael White, Michael Henry, Levi Filler Source Type: research

Hyperosmolar Hyperglycemic State
Hyperosmolar hyperglycemic state (HHS) is an underrecognized diabetic emergency with high morbidity and mortality. Many features of HHS overlap with those of diabetic ketoacidosis but key differentiators for HHS are serum osmolality greater than 320 mOsm/kg, lack of metabolic acidosis, and minimal to no presence of ketones. HHS is often triggered by an underlying illness —most commonly infection but may also be triggered by stroke, acute coronary syndrome, and other acute illnesses. Treatment guidelines recommend aggressive volume-repletion of osmotic losses in addition to insulin therapy, plus treatment of the underlying cause.
Source: Emergency Medicine Clinics of North America - August 18, 2023 Category: Emergency Medicine Authors: Spencer S. Lovegrove, Sarah B. Dubbs Source Type: research

An analysis of racial inequities in emergency department triage among patients with stroke-like symptoms in the United States
Racial inequities exist in treatment and outcomes in patients with acute stroke.
Source: BMC Emergency Medicine - August 14, 2023 Category: Emergency Medicine Authors: Gabriel Neves, John DeToledo, James Morris and K. Tom Xu Tags: Research Source Type: research

The impact on clinical outcomes after 1  year of implementation of an artificial intelligence solution for the detection of intracranial hemorrhage
ConclusionThe added value of this study emphasizes the introduction of artificial intelligence (AI) computer-aided triage and prioritization software in an emergent care setting that demonstrated a significant reduction in a 30- and 120-day all-cause mortality and morbidity for patients diagnosed with intracranial hemorrhage (ICH). Along with mortality rates, the AI software was associated with a significant reduction in the Modified Ranking Scale (mRs).
Source: International Journal of Emergency Medicine - August 11, 2023 Category: Emergency Medicine Source Type: research

Pearls for the Emergency Clinician: Posterior Circulation Stroke
Posterior circulation (PC) stroke in adults is a rare, frequently misdiagnosed, serious condition that carries with it a high rate of morbidity.
Source: The Journal of Emergency Medicine - July 20, 2023 Category: Emergency Medicine Authors: Jessica Pelletier, Alex Koyfman, Brit Long Source Type: research

Single-step Optimization in Triaging Large Vessel Occlusion Strokes: Identifying Factors to Improve Door-to-groin Time for Endovascular Therapy
Introduction: Although acute stroke endovascular therapy (EVT) has dramatically improved outcomes in acute ischemic stroke (AIS) patients with large vessel occlusions (LVO), access to EVT-capable centers remains limited, particularly in rural areas. Therefore, it is essential to optimize triage systems for EVT-eligible patients. One strategy may be the use of a telestroke network that typically consists of multiple spoke sites that receive a consultation to determine appropriateness of patient transfer to an EVT-capable hub site. Standardization of AIS protocols may be necessary to achieve target door-to groin (DTG) times ...
Source: Western Journal of Emergency Medicine - June 30, 2023 Category: Emergency Medicine Authors: Rawson, Joshua Source Type: research

Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke
AbstractTo investigate the association between the Emergency Medical Service dispatcher ’s initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017–2018) were in cluded if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1–76.0) co...
Source: Internal and Emergency Medicine - June 27, 2023 Category: Emergency Medicine Source Type: research

Systemic thrombolysis in patients with acute stroke and active cancer: a systematic review and meta-analysis
AbstractCancer patients frequently have concomitant cerebrovascular diseases, which significantly worsen their prognosis. Prospective studies validating intravenous thrombolysis (IVT) safety profile in patients with acute ischemic stroke and active cancer are still lacking. Therefore, we aimed to evaluate IVT ’s efficacy and safety profile in acute ischemic stroke patients with comorbid active cancer. We included in a meta-analysis all relevant published studies, including patients with acute ischemic stroke with or without active cancer and receiving IVT, according to recommendations for IVT treatment for acute ischemic...
Source: Internal and Emergency Medicine - June 19, 2023 Category: Emergency Medicine Source Type: research

Higher serum uric acid is associated with poorer cognitive performance in healthy middle-aged people: a cross-sectional study
AbstractAge-related cognitive impairment can occur many years before the onset of the clinical symptoms of dementia. Uric acid (UA), a metabolite of purine-rich foods, has been shown to be positively associated with improved cognitive function, but such association remains controversial. Moreover, most of the previous studies investigating the association included elderly participants with memory-related diseases. Therefore, the present study aimed at investigating whether serum UA (sUA) is associated with cognitive performance in healthy middle-aged individuals. We conducted a cross-sectional study on a cohort of middle-a...
Source: Internal and Emergency Medicine - June 17, 2023 Category: Emergency Medicine Source Type: research