Podcast #412: tPa Mission Creep

Podcast #412: tPa Mission Creep

Author: Aaron Lessen, MD

Educational Pearls:

  • Patients with "minor" strokes with NIHSS 0 to 5 can still end up having poor long-term outcomes
  • Recent study compared use of alteplase vs. aspirin for these patients and saw no difference in regards to favorable neurologic outcome at 90 days
  • Study was ended early due to patient recruitment difficulties

Editor's note: though ended early, it is debatable whether even if appropriately powered there would have been an identifiable benefit

References:

Khatri P, Kleindorfer DO, Devlin T, Sawyer RN Jr, Starr M, Mejilla J, Broderick J, Chatterjee A, Jauch EC, Levine SR, Romano JG, Saver JL, Vagal A, Purdon B, Devenport J, Pavlov A, Yeatts SD; PRISMS Investigators. Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. JAMA. 2018 Jul 10;320(2):156-166. doi: 10.1001/jama.2018.8496. PubMed PMID: 29998337.

Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD

Episoder(1149)

Episode 970: Fever Management

Episode 970: Fever Management

Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer...

22 Aug 20252min

Episode 969: Shoulder Reduction

Episode 969: Shoulder Reduction

Contributor: Aaron Lessen, MD Educational Pearls: There are many techniques for reducing a shoulder dislocation A recent study discussed a new variation of closed reduction technique: wrist-clamping ...

11 Aug 20252min

Episode 968: Heavy Metals

Episode 968: Heavy Metals

Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals: Gastrointestinal upset is the most common presentation Chronic toxicity of heavy metals: Symptoms depend on the meta...

4 Aug 20252min

Episode 967: Dilutional Hyponatremia

Episode 967: Dilutional Hyponatremia

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration witho...

28 Jul 20252min

EMSAC 2024

EMSAC 2024

Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac ...

26 Jul 202511min

Episode 966: Acetaminophen Toxicity

Episode 966: Acetaminophen Toxicity

Contributor: Jorge Chalit-Hernandez, OMS4 Educational Pearls: What is the toxic dose of acetaminophen? 7.5 grams, in an adult. The safe daily limit is 4 grams in an adult with a normally functioning...

21 Jul 20253min

Episode 965: Oxygen Administration in Trauma Patients

Episode 965: Oxygen Administration in Trauma Patients

Contributor: Aaron Lessen, MD Educational Pearls: Many trauma patients are placed on oxygen via non-rebreather A large, multicenter, controlled trial evaluated the outcomes of oxygen administration i...

14 Jul 20252min

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a p...

7 Jul 20254min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
forskningno
sinnsyn
rss-rekommandert
smart-forklart
liberal-halvtime
villmarksliv
jss
fjellsportpodden
pod-britannia
vett-og-vitenskap-med-gaute-einevoll
tomprat-med-gunnar-tjomlid
rss-paradigmepodden
psykopoden
dekodet-2
rss-nysgjerrige-norge
nevropodden
rss-overskuddsliv