Recurrent Low Risk Chest Pain: GRACE Guidelines

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Recurrent Low Risk Chest Pain: GRACE Guidelines

When providers are early in their training, this tends to lead to questions of “how long is a negative stress test good for?” “What about a negative cath? - Is that good for 2 years, 4, years, 6?” “What about a negative CCTA?”

In the first (of many to come) GRACE guidelines (Guidelines for Reasonable and Appropriate Care in the Emergency Department), SAEM sought to tackle many of these questions as they looked at Recurrent, Low-risk Chest Pain in the Emergency Department.

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Intrathecal Baclofen Withdrawal

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Intrathecal Baclofen Withdrawal

Intrathecal baclofen withdrawal is characterized by increased spasticity, hypertension, tachycardia, hyperthermia, altered mental status, and seizures. In the most severe cases, autonomic instability, rhabdomyolysis, diffuse intravascular coagulopathy, multisystem organ failure, and death can occur.  In this episode of the research corner, we cover a recently published case report where intrathecal baclofen withdrawal was treated successfully with dexmedetomidine.

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Prehospital Stroke Triage

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Prehospital Stroke Triage

Over the past 5 years, there has been a dramatic expansion of the treatment strategies used to treat patients with acute ischemic stoke. As some of these treatments involve specific resources only available at certain institutions, appropriate triage of patients in the prehospital environment is becoming ever important. On one hand a patient who would best benefit from endovascular treatment triaged to a center without that capability will undoubtedly suffer a delay in care. On the other hand, over-triaging stroke patients to a comprehensive stroke center could overwhelm the resources of that center, potentially impacting the care of patients at that center. In the podcast below, we talk with Dr. Jason McMullan of the UC EM Division of EMS and Dr. James Li, PGY-3 who both have recent publications focusing on this phase of patient care.

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