Episodes
Sunday Dec 11, 2022
Sunday Dec 11, 2022
Speakers:
- Arianna Campbell, PA-C (Marshall Medical Center)
- Aimee Moulin, MD FACEP (Professor of Emergency Medicine at University of California Davis, Chief of the Division of Addiction Medicine)
Host: Jason Woods, MD (Assistant Professor of Pediatrics - Emergency Medicine, University of Colorado)
Audio engineer: Kellen Vu (Stanford University)
Thursday Jun 16, 2022
ACEP E-QUAL 51: Stroke Systems of Care
Thursday Jun 16, 2022
Thursday Jun 16, 2022
Guest: Edward Jauch MD, MS (Chief of System Research, Mission Health System, Asheville, NC)
Host: Jason Woods MD
References:
- Jauch EC, Cucchiara B, Adeoye O, Meurer W, Brice J, Chan YY, Gentile N, Hazinski MF. Part 11: adult stroke: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S818-28. doi: 10.1161/CIRCULATIONAHA.110.971044. Erratum in: Circulation. 2011 Oct 11;124(15):e404. PMID: 20956227.
- Dall TM, Storm MV, Chakrabarti R, Drogan O, Keran CM, Donofrio PD, Henderson VW, Kaminski HJ, Stevens JC, Vidic TR. Supply and demand analysis of the current and future US neurology workforce. Neurology. 2013 Jul 30;81(5):470-8. doi: 10.1212/WNL.0b013e318294b1cf. Epub 2013 Apr 17. PMID: 23596071; PMCID: PMC3776531.
- Kronick SL, Kurz MC, Lin S, Edelson DP, Berg RA, Billi JE, Cabanas JG, Cone DC, Diercks DB, Foster JJ, Meeks RA, Travers AH, Welsford M. Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S397-413. doi: 10.1161/CIR.0000000000000258. PMID: 26472992.
- Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, Khalessi AA, Bushnell C, Barsan WG, Panagos P, Alberts MJ, Tiner AC, Schwamm LH, Jauch EC. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update. Stroke. 2019 Jul;50(7):e187-e210. doi: 10.1161/STR.0000000000000173. Epub 2019 May 20. Erratum in: Stroke. 2020 Apr;51(4):e70. PMID: 31104615.
Thursday Jun 16, 2022
ACEP E-QUAL 50: tPA for Stroke and Litigation
Thursday Jun 16, 2022
Thursday Jun 16, 2022
This episode is a rapid fire review of litigation issues surrounding the provision of (or lack of provision of) tPA for stroke.
Guests:
Latha Ganti, MD, MS, MBA
Professor of Emergency Medicine & Neurology ,University of Central Florida College of Medicine
Joshua N. Goldstein MD, PhD
Professor of Emergency Medicine, Harvard Medical School
Host: Jason Woods MD
References:
- Chernyshev OY, Martin-Schild S, Albright KC, Barreto A, Misra V, Acosta I, Grotta JC, Savitz SI. Safety of tPA in stroke mimics and neuroimaging-negative cerebral ischemia. Neurology. 2010 Apr 27;74(17):1340-5. doi: 10.1212/WNL.0b013e3181dad5a6. Epub 2010 Mar 24. PMID: 20335564; PMCID: PMC2875935.
- Gebel JM, Sila CA, Sloan MA, Granger CB, Mahaffey KW, Weisenberger J, Green CL, White HD, Gore JM, Weaver WD, Califf RM, Topol EJ. Thrombolysis-related intracranial hemorrhage: a radiographic analysis of 244 cases from the GUSTO-1 trial with clinical correlation. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. Stroke. 1998 Mar;29(3):563-9. doi: 10.1161/01.str.29.3.563. PMID: 9506593.
- Kass J et al. CONTINUUM (MINNEAP MINN) 2020;26(2, CEREBROvascular disease): 499-505
Thursday Jun 16, 2022
ACEP E-QUAL 49: Code Stroke | Optimizing ED Stroke Response
Thursday Jun 16, 2022
Thursday Jun 16, 2022
Guest: Adam Oostema, MD MS FACEP (Associate Professor of EM, Michigan State University College of Human Medicine)
Host: Jason Woods MD
Select References:
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995 Dec 14;333(24):1581-7. doi: 10.1056/NEJM199512143332401. PMID: 7477192.
- Saver JL, Gornbein J, Starkman S. Graphic reanalysis of the two NINDS-tPA trials confirms substantial treatment benefit. Stroke. 2010 Oct;41(10):2381-90. doi: 10.1161/STROKEAHA.110.583807. Epub 2010 Sep 9. PMID: 20829518; PMCID: PMC2949055.
- Kwiatkowski TG et al. Effects of tissue plasminogen activator for acute ischemic stroke at one year. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. N Engl J Med. 1999 Jun 10;340(23):1781-7. doi: 10.1056/NEJM199906103402302. PMID: 10362821.
- Ingall TJ et al. Findings from the reanalysis of the NINDS tissue plasminogen activator for acute ischemic stroke treatment trial. Stroke. 2004 Oct;35(10):2418-24. doi: 10.1161/01.STR.0000140891.70547.56. Epub 2004 Sep 2. PMID: 15345796.
- Emberson J et al. Stroke Thrombolysis Trialists' Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014 Nov 29;384(9958):1929-35. doi: 10.1016/S0140-6736(14)60584-5. Epub 2014 Aug 5. PMID: 25106063; PMCID: PMC4441266.
- Hacke W et al. ECASS Investigators. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008 Sep 25;359(13):1317-29. doi: 10.1056/NEJMoa0804656. PMID: 18815396.
- Alper BS et al. Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances. BMJ Evid Based Med. 2020 Oct;25(5):168-171. doi: 10.1136/bmjebm-2020-111386. Epub 2020 May 19. PMID: 32430395; PMCID: PMC7548536.
- Powers WJ et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30. Erratum in: Stroke. 2019 Dec;50(12):e440-e441. PMID: 31662037.
Thursday Mar 03, 2022
ACEP E-QUAL 48: Supporting New Buprenorphine Providers
Thursday Mar 03, 2022
Thursday Mar 03, 2022
In this episode from ACEP E-QUAL, we feature Dr. Jeanmarie Perrone (@JMPerroneMD), Professor of Emergency Medicine and the Director of the Center for Addiction Medicine and Policy at the University of Pennsylvania.
Host: Jason Woods, MD
Sound Engineer: Kellen Vu
Thursday Mar 03, 2022
ACEP E-QUAL 47: Harm Reduction in the Emergency Department
Thursday Mar 03, 2022
Thursday Mar 03, 2022
In this episode from ACEP E-QUAL, Dr. Bill Soares is an Associate Professor of EM and Director of Harm Reduction Services in the Deptartment of Emergency Medicine at Bay State Medical Center. He also serves as a Fellow at the Institute of Health Care Delivery and Population Science at the University of Massachusetts Chan School of Medicine.
Host: Jason Woods, MD
Sound Engineer: Kellen Vu
Tuesday Dec 21, 2021
ACEP E-QUAL 46: Opioids and Social Emergency Medicine
Tuesday Dec 21, 2021
Tuesday Dec 21, 2021
In this episode from ACEP E-QUAL, Dr. Elizabeth Samuels discusses a social emergency medicine approach to opioid use disorder.
- Guest: Elizabeth A. Samuels, MD MPH MHS, Brown Emergency Medicine
- Host: Jason Woods MD
Select references:
- Weiner SG, Baker O, Bernson D, Schuur JD. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Ann Emerg Med. 2020 Jan;75(1):13-17. doi: 10.1016/j.annemergmed.2019.04.020. Epub 2019 Jun 20. PMID: 31229387; PMCID: PMC6920606.
- Wakeman SE, Larochelle MR, Ameli O, et al. Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622
- Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, Bagley SM, Liebschutz JM, Walley AY. Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study. Ann Intern Med. 2018 Aug 7;169(3):137-145. doi: 10.7326/M17-3107. Epub 2018 Jun 19. PMID: 29913516; PMCID: PMC6387681.
- Kilaru AS, Xiong A, Lowenstein M, et al. Incidence of Treatment for Opioid Use Disorder Following Nonfatal Overdose in Commercially Insured Patients. JAMA Netw Open. 2020;3(5):e205852. Published 2020 May 1. doi:10.1001/jamanetworkopen.2020.5852
- D'Onofrio G, O'Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015 Apr 28;313(16):1636-44. doi: 10.1001/jama.2015.3474. PMID: 25919527; PMCID: PMC4527523.
- Hawk KF, D’Onofrio G, Chawarski MC, et al. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Netw Open. 2020;3(5):e204561. doi:10.1001/jamanetworkopen.2020.4561
Monday Nov 09, 2020
ACEP E-QUAL 45: Protected Code Stroke
Monday Nov 09, 2020
Monday Nov 09, 2020
In this episode from the ACEP E-QUAL series, guest Dr. Houman Khosravani (Medical Director, Inpatient Stroke Unit Assistant Professor of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Center; Staff Intensivist, Southlake Regional Health Center) discusses the concept of a "protected code stroke", how to operationalize the concepts, and how this system can be applied in your local circumstances. Host: Jason Woods, MD. Podcast sound engineer: Kellen Vu. www.acep.org/equal
References
Rajendram P, Notario L, Reid C, Wira CR, Suarez JI, Weingart SD, Khosravani H. Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical Care. 2020; 33(2), 338–346. https://doi.org/10.1007/s12028-020-01057-4
Monday Nov 02, 2020
ACEP E-QUAL 44: Stroke transfer protocolization
Monday Nov 02, 2020
Monday Nov 02, 2020
In this episode from the ACEP-EQUAL series, guest Dr. William Meurer (Associate Professor of Emergency Medicine and Neurology University of Michigan) discuss how to protocolize of transferring stroke patients, how to identify and appropriately chose transfer destinations, and how to better align patient needs with the resources of the receiving sites. Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu. www.acep.org/equal
- Saver JL, Goyal M, van der Lugt A, et al; HERMES Collaborators. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647. PMID: 27673305.
- Campbell BCV, Mitchell PJ, Churilov L, et al; EXTEND-IA TNK Part 2 investigators. Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial. JAMA. 2020 Apr 7;323(13):1257-1265. doi: 10.1001/jama.2020.1511. PMID: 32078683; PMCID: PMC7139271.
- Prabhakaran S, O'Neill K, Stein-Spencer L, Walter J, Alberts MJ. Prehospital triage to primary stroke centers and rate of stroke thrombolysis. JAMA Neurol. 2013 Sep 1;70(9):1126-32. doi: 10.1001/jamaneurol.2013.293. PMID: 23817961.
Monday Oct 26, 2020
ACEP E-QUAL 43: Intracranial Hemorrhage Scoring and Prognostication
Monday Oct 26, 2020
Monday Oct 26, 2020
In this episode from the ACEP-EQUAL series, guest Dr. Bruce Lo (Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital; Professor of Emergency Medicine, Eastern Virginia Medical School) reviews several common intracerebral hemorrhage scoring systems, the components, and tips on how to use them in real world practice.
Host: Jason Woods, MD; Podcast Sound Engineer: Kellen Vu
References
- Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001 Apr;32(4):891-7. doi: 10.1161/01.str.32.4.891. PMID: 11283388.
- Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC 3rd. External validation of the ICH score. Neurocrit Care. 2004;1(1):53-60. doi: 10.1385/NCC:1:1:53. PMID: 16174898.
- Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Chaves PC, Azevedo L. Assessment and Comparison of the Four Most Extensively Validated Prognostic Scales for Intracerebral Hemorrhage: Systematic Review with Meta-analysis. Neurocrit Care. 2019 Apr;30(2):449-466. doi: 10.1007/s12028-018-0633-6. PMID: 30426449.
- Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C. Intracerebral hemorrhage outcome: A comprehensive update. J Neurol Sci. 2019 Mar 15;398:54-66. doi: 10.1016/j.jns.2019.01.013. Epub 2019 Jan 14. PMID: 30682522.
- Øie LR, Madsbu MA, Solheim O, Jakola AS, Giannadakis C, Vorhaug A, Padayachy L, Jensberg H, Dodick D, Salvesen Ø, Gulati S. Functional outcome and survival following spontaneous intracerebral hemorrhage: A retrospective population-based study. Brain Behav. 2018 Oct;8(10):e01113. doi: 10.1002/brb3.1113. Epub 2018 Sep 21. PMID: 30240164; PMCID: PMC6192392.
- Hemphill JC 3rd, Greenberg SM, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Jul;46(7):2032-60. doi: 10.1161/STR.0000000000000069. Epub 2015 May 28. PMID: 26022637.
- Houben R, Schreuder FHBM, Bekelaar KJ, et al. Predicting Prognosis of Intracerebral Hemorrhage (ICH): Performance of ICH Score Is Not Improved by Adding Oral Anticoagulant Use. Front Neurol. 2018 Feb 28;9:100. doi: 10.3389/fneur.2018.00100. PMID: 29541054; PMCID: PMC5836590.