Ep 120 ED Stroke Management in the Age of Endovascular Therapy

In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we’ll try to simplify the confusing time-based and brain tissue-based options for stroke management. We’ll answer the questions that have been plaguing us for a while now: Which patients are eligible for endovascular therapies? Which patients are the ones who’ll benefit from these therapies and how do we make that happen in our different practice environments? Which patients should be considered for lytic therapy? Which patients should be considered for both lytic and endovascular therapy? and many more...

BCE 74 Coding in the Scanner

In anticipation of EM Cases Episode 113 Diagnosis an Workup of Pulmonary Embolism with Dr. Kerstin DeWit and Dr. Eddy Lang, we have Dr. Peter Reardon telling us his Best Case Ever (Coding in the Scanner) of a young woman who presents with a seizure followed by hemodynamic instability, who codes while in the CT scanner...

Journal Jam 10 Thrombolysis & Endovascular Therapy for Stroke Part 1

In this two part EM Cases Journal Jam podcast Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on systemic thrombolysis for ischemic stroke followed by an analysis of endovascular therapy for stroke. We elucidate the important issues related to p-values, ordinal analysis, fragility index, heterogeneity of studies, stopping trials early and conflicts of interest related to this body of evidence. While "calling a code stroke" is now considered standard for most stroke patients and tPA for stroke is considered a class 1A drug, a close look at the literature tells us that the evidence is not as strong as our stroke protocols suggest...