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Pre-Hospital Stroke Care
Prehospital Medicine Jeffery Hill, MD M.Ed Prehospital Medicine Jeffery Hill, MD M.Ed

Pre-Hospital Stroke Care

Pre-hospital stroke care begins with a quick, simple assessment tool used to help identify patients that are suffering a stroke.  In Southwest Ohio, this tool is the Cincinnati Pre-hospital Stroke Scale (CPSS).  There are three simple components of the CPSS – facial droop, arm drift, and slurred speech.  When assessing for facial droop, it is best to ask patients to bear their teeth.  Arm drift is assessed by asking the patient to hold both arms outstretched in front of them with their palms facing up.  If one arm drifts down or one hand rotates to a palm-down position, this aspect of the scale is positive.  Lastly, ask the patient to repeat a sentence to assess for slurred speech or any other type of speech abnormality.

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Grand Rounds Recap 5/4
Grand Rounds Ryan LaFollette, MD Grand Rounds Ryan LaFollette, MD

Grand Rounds Recap 5/4

Acetaminophen Toxicity Sim - Drs. LaFollette, Nelson and Toth

Take a read through our Cases If It Bleeds it Leads..., Seeing is Believing..., and Belly Pain Bonanza. Curated commentary to follow

Acetaminophen Toxicity

  • 60,000 poisonings / year
  • ~500 deaths per year, evenly split therapeutic / suicide
  • Mechanism - acetaminophen to NAPQI by P450, overwhelming gluthathione stores
  • Alcohol, phenytoin, isoniazid all induce P450 and may increase NAPQI production. Chronic alcohol use will worsen toxicity when acute ingestion will competitively inhibit and can be preventative at producing the toxic metabolite
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Clinical Concepts in Pelvic Ultrasound
Diagnostics, Intern Radiology Videos Courtney McKee, MD Diagnostics, Intern Radiology Videos Courtney McKee, MD

Clinical Concepts in Pelvic Ultrasound

Your patient is a well appearing, otherwise healthy 22 year old female who presents with lower abdominal pain x3 days.  She is unsure of her LMP, but thinks she had some spotting about a month ago.  Vital signs: Temp 99.3F, HR 92, BP 102/70, RR 20, 98% on RA.  She has a benign, non-gravid abdomen.  Urine pregnancy is positive.  You fire off a quantitative hCG and don’t expect that result to come back for a while.  What do you do next?  

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