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In this episode of the PFC Podcast, Dennis, Paul, and Ian discuss the critical topic of cold weather injuries, focusing on frostbite and trench foot. Ian shares his extensive experience in wilderness medicine and military contexts, providing historical insights into the impact of these injuries in warfare. The conversation covers prevention strategies, treatment protocols, and the importance of buddy checks in cold environments. Ian explains the pathophysiology of frostbite, the classification of injuries, and the role of thrombolytics in treatment. The episode concludes with a discussion on trench foot, emphasizing the need for proper foot care and hydration to prevent these injuries. Takeaways Frostbite and trench foot have significant historical military implications. Prevention is key in avoiding cold weather injuries. Buddy checks can help identify early signs of frostbite. Rapid rewarming in warm water is the best treatment for frostbite. Thrombolytics can help reduce tissue loss if administered early. Trench foot requires slow, dry rewarming and careful monitoring. Frostbite classification helps determine treatment and prognosis. Hydration and keeping feet dry are crucial for preventing trench foot. Avoid using active heat sources for rewarming frostbite. Rubbing frostbite with snow is a dangerous myth. Chapters 00:00 Introduction to Cold Weather Injuries 01:49 Historical Context of Cold Weather Injuries 03:14 Understanding Frostbite and Non-Freezing Cold Injuries 05:51 Prevention Strategies for Cold Weather Injuries 09:06 Buddy Checks and Hydration 10:58 Pathophysiology of Frostbite 14:01 Treatment Protocols for Frostbite 20:03 Evacuation Considerations for Frostbite 24:42 Assessment and Classification of Frostbite 30:25 Thrombolytics and Their Role in Treatment 36:11 Trench Foot: Understanding and Treatment 45:39 Conclusion and Key Takeaways Thank you to Delta Development Team for in part, sponsoring this podcast. deltadevteam.com For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
Two new trials published in JAMA evaluate the efficacy of periprocedural intra-arterial thrombolytics after successful endovascular thrombectomy for patients with acute ischemic stroke. Diederik Dippel, MD, PhD, of Erasmus University Medical Center discusses this and more with JAMA Deputy Editor Christopher C. Muth, MD. Related Content: Intra-Arterial Thrombolytics During Thrombectomy for Ischemic Stroke—End of the Story or a New Beginning? Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke
Podcast summary of articles from the November 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include CPR, COPD, Prolonged QT syndrome, SVT, thrombolytics for pulmonary embolisms, and phenobarbital for alcohol withdrawal. Guest speaker is Dr. Kinda Sweidan.
مروری بر کاربردهای ترومبولیتیک در سکتهی مغزی ایسکمیک
In this episode, we review the high-yield topic of Thrombolytics from the Heme section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
Contributor: Aaron Lessen MD Educational Pearls: How is the severity of a stroke assessed? Strokes are assessed by the NIH Stroke Scale (NIHSS), this scale has different tasks, such as asking the person to repeat words, move their arms, or follow simple instructions. The maximum score is 42 but any score over 21 is considered severe. What would qualify as a minor storke? NIH
Acute Coronary Syndromes (ACS) Special Guest: Nick Servati, PharmD, BCCP 04:55 – Pathophysiology/Clinical presentation 12:40 – “MONA” myths 20:05 – P2Y12 pretreatment 24:25 – Thrombolytics in ACS 30:35 – Anticoagulation 38:55 – Vasopressors/Inotropes 49:50 – IV antiplatelet agents 60:10 – STEMI pharmacotherapy checklist 66:00 – Future research/Take-home points Reference List: https://pharmacytodose.files.wordpress.com/2023/09/acute-coronary-syndromes-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
Thrombolytics are the standard of care for acute stroke yet are not without risk. Join host, Geoff Wall, with guest, Jake Galdo, as they discuss combination aspirin and clopidogrel versus thrombolytics in mild stroke. The GameChangerThrombolytic use in mild stroke is common due to the time factor of administration, but data is mixed. New research has shown DAPT to be non-inferior to TPA. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthJake Galdo, PharmD, MBA, BCPS, BCGPCourse Content and Developer, CEimpactManaging Network Facilitator, CPESN Health EquityCEO, Seguridad ReferenceChen H, Cui Y, Zhou Z, et al. Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial. JAMA. 2023;329(24):2135–2144. doi:10.1001/jama.2023.7827https://jamanetwork.com/journals/jama/article-abstract/2806532 Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss how the inclusion and exclusion criteria impact the interpretation of the ARIMIS study 2. Describe the potential benefits of DAPT therapy compared to thrombolytic therapy in mild stroke0.05 CEU/0.5 HrUAN: 0107-0000-23-249-H01-PInitial release date: 7/31/2023Expiration date: 7/31/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!
This week our Co-Host and producer is the guest once again! The topic for this week is Pulmonary Embolism, which is a blood clot or thrombus in the lung. A pulmonary embolism (PE) is a sudden blockage in a lung artery. It usually happens when a blood clot breaks loose and travels through the bloodstream to the lungs. PE is a serious condition that can cause: Permanent damage to the lungs Low oxygen levels in your blood Damage to other organs in your body from not getting enough oxygen PE can be life-threatening, especially if a clot is large, or if there are many clots. What causes a pulmonary embolism (PE)? The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lungs. Who is at risk for a pulmonary embolism (PE)? Anyone can get a pulmonary embolism (PE), but certain things can raise your risk of PE: Having surgery, especially joint replacement surgery Certain medical conditions, including Cancers Heart diseases Lung diseases A broken hip or leg bone or other trauma Hormone-based medicines, such as birth control pills or hormone replacement therapy Pregnancy and childbirth. The risk is highest for about six weeks after childbirth. Not moving for long periods, such as being on bed rest, having a cast, or taking a long plane flight Age. Your risk increases as you get older, especially after age 40. Family history and genetics. Certain genetic changes that can increase your risk of blood clots and PE. Obesity What are the symptoms of a pulmonary embolism (PE)? Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg. How is a pulmonary embolism (PE) diagnosed? It can be difficult to diagnose PE. To make a diagnosis, your health care provider will: Take your medical history, including asking about your symptoms and risk factors for PE Do a physical exam Run some tests, including various imaging tests and possibly some blood tests What are the treatments for a pulmonary embolism (PE)? If you have PE, you need medical treatment right away. The goal of treatment is to break up clots and help keep other clots from forming. Treatment options include medicines and procedures. Medicines: Anticoagulants, or blood thinners, keep blood clots from getting larger and stop new clots from forming. You might get them as an injection, a pill, or through an I.V. (intravenous). They can cause bleeding, especially if you are taking other medicines that also thin your blood, such as aspirin. Thrombolytics are medicines to dissolve blood clots. You may get them if you have large clots that cause severe symptoms or other serious complications. Thrombolytics can cause sudden bleeding, so they are used if your PE is serious and may be life-threatening. Procedures: Catheter-assisted thrombus removal uses a flexible tube to reach a blood clot in your lung. Your health care provider can insert a tool in the tube to break up the clot or to deliver medicine through the tube. Usually you will get medicine to put you to sleep for this procedure. A vena cava filter may be used in some people who cannot take blood thinners. Your health care provider inserts a filter inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. But the filter does not stop new blood clots from forming. Can pulmonary embolism (PE) be prevented? Preventing new blood clots can prevent PE. Prevention may include: Continuing to take blood thinners. It's also important to get regular checkups with your provider, to make sure that the dosage of your medicines is working to prevent blood clots but not causing bleeding. Heart-healthy lifestyle changes, such as heart-healthy eating, exercise, and, if you smoke, quitting smoking Using compression stockings to prevent deep vein thrombosis (DVT) Moving your legs when sitting for long periods of time (such as on long trips) Moving around as soon as possible after surgery or being confined to a bed (Credits: NIH)
A stroke is an emergency! We need to break down that clot, enter the thrombo(clot) lytics(disintegrate) class of drugs. --- Support this podcast: https://podcasters.spotify.com/pod/show/wambui-wamburu/support
In this episode, we review the high-yield topic of Thrombolytics from the Hematology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
This week, Rob and Zach will be talking about Anticoagulants, Thrombolytics, and Antiplatelet AgentsWe will be discussing the following topics within this episode on Anticoagulants, Thrombolytics, and Antiplatelet Agents!Hemostasis: Coagulation Cascade, Extrinsic + Intrinsic PathwayAnticoagulants:HeparinUFHLMWHFondaparinux Direct Factor InhibitorsXa Inhibitors:RivaroxabanApixabanEdoxabanThrombin Inhibitors:DabigatranArgatrobanBivalirudinVitamin K Antagonists:Warfarin (Coumadin)Thrombolytics (tPA):AlteplaseReteplaseTenecteplaseStreptokinaseUrokinaseAntiplatelets:AspirinP2y12 Receptor Blockers:ClopidogrelTicagrelorPrasugrelTiclopidineGP2b/3a Inhibitors:AbciximabEptifibatideTirofibanPDE-3 Inhibitors:CilostazolAnticoagulants, Thrombolytics, Antiplatelet Agents MOATherapeutic IndicationsAdverse Drug Reactions (ADR's)Drug ComplicationsTo follow along with Notes & Illustrations for our podcasts please become a member on our website! https://www.ninjanerd.org/podcast/anticoagulants-thrombolytics-and-antiplatelet-agentsFollow us on:YouTube: https://www.youtube.com/ninjanerdscienceInstagram: https://www.instagram.com/ninjanerdlecturesFacebook: https://www.facebook.com/NinjaNerdLecturesTwitter: https://twitter.com/ninjanerdsciDiscord: https://discord.com/invite/3srTG4dngWTikTok: https://www.tiktok.com/@ninjanerdlecturesThe Foundation of Daily Health, AG1 by Athletic GreensUnlock Your Free One Year Supply of Vitamin D3+K2 and 5 free Travel Packs Support the show
Treatment strategies for acute ischemic stroke are continuing to evolve. JAMA Associate Editor and vascular neurologist Jeffrey Saver, MD, from the University of California Los Angeles, and JAMA Senior Editor Christopher Muth, MD, discuss 2 articles recently published in JAMA about alteplase in the treatment of acute ischemic stroke and provide a broader overview of the recent advances and future directions for the use of thrombolytics and endovascular thrombectomy for acute ischemic stroke.Treatment strategies for acute ischemic stroke are continuing to evolve. JAMA Associate Editor and vascular neurologist Jeffrey Saver, MD, from the University of California Los Angeles, and JAMA Senior Editor Christopher Muth, MD, discuss 2 articles recently published in JAMA about alteplase in the treatment of acute ischemic stroke, and provide a broader overview of the recent advances and future directions for the use of thrombolytics and endovascular thrombectomy for acute ischemic stroke. Related Content: Association of Recent Use of Non–Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase
The First Principles of Stroke that can get you through the stroke ward: Virchow's Triad, our friend HAL, and the 4 brain regions. === Other Links === Accompanying Notion document with Free Ankis, Detailed Information, and Figures: https://bit.ly/3QTWtRT Check out our Instagram: https://www.instagram.com/firstprinciplesofmedicine/ Recorded 15 February 2022 Co-hosts: JT Yeung, Adian Izwan, Jason D'Silva, Daniel Bontempo If you have any ideas or feedback, comment on this Notion document, or shoot us an email at firstprinciplesofmedicine@gmail.com === Timestamps === (00:09) Introduction (00:42) Some fun stroke trivia (04:34) First Principles - Virchow's Triad (09:06) First Principles - Neuroanatomy (10:31) HAL the Homunculus (15:44) Quantifying Nangs (17:50) Stroke risk factors (22:51) M classification (24:25) Clinical features (31:00) Management (32:33) CTs – more than one? (39:01) Thrombolytics (43:12) Stroke Transformation (44:17) Recap (45:50) Fact checks
Cassandra J. Schmitt, PharmD (@cjschmitt2) Identifies the risk stratifications for submassive pulmonary embolism, discusses efficacy and safety outcomes for thrombolytics in submassive pulmonary embolism and selects the ideal candidate to receive thrombolysis for a submassive pulmonary embolism. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
The Simple Nursing Podcast - The Simplest Way To Pass Nursing School
Hematology blood thinner meds. Thrombolytics. Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
Critical Care Management of COVID-19Special Guests: Drayton Hammond, PharmD, MBA, MSc, BCPS, BCCCP, FCCMPeter Nikolos, PharmD Show Notes: https://pharmacytodose.files.wordpress.com/2020/04/covid-19-complications-show-notes.pdf Mechanical Ventilation (Drayton)08:00 – Non-COVID-19 PAD management; 11:16 – COVID-19 PAD management; 18:22 – Managing PAD drug shortages; 22:38 – Opioid conservation strategies; 26:08 – Propofol conservation strategies; 29:08 – Hypertriglyceridemia with propofol; 32:10 – Risk of PRIS; 34:30 – Ketamine; 41:05 – NMBA use and shortage; 46:00 – PPE conservation; 49:00 – Bronchodilator use for COVID-19; 50:28 – Inhaled anticoagulants; 52:46 – Inhaled pulmonary vasodilators; 54:17 – Advice for COVID-19 management Cardiovascular (Peter)67:20 – Current shortages; 71:05 – First-line vasopressor; 73:25 – Vasopressor compounding and utilization changes; 74:50 – Smart pump management; 77:15 – Vasopressor shortage management; 79:45 – Anticoagulation treatment strategy; 85:30 – Anticoagulation monitoring; 86:28 – Anticoagulation in ECMO/CRRT; 88:20 – PE causing rapid decompensation?; 90:25 – Alternate anticoagulants; 92:52 – Thrombolytics in ACS; 98:13 – Code response changes; 100:05 – ACE-I/ARB use in COVID-19; 103:41 – NSAID use in COVID-19; 105:15 – Statin use in COVID-19; 107:25 – Challenges from virtual rounding; 110:20 – Key points on COVID-19 management PharmacyToDose.Com@PharmacyToDose on Twitter/InstagramPharmacyToDose@Gmail.com
Each month, EMedHome.com presents EMCast, the 90-minute podcast hosted by Dr. Amal Mattu, the premier educator in Emergency Medicine. Subscribe to EMedHome.com for an array of clinical content that will impact every shift. This month's EMCast covers:(1) Type 2 Acute Coronary Syndrome(2) Acute Severe Hypertension(3) Fournier’s Gangrene(4) Pulmonary Embolism and Thrombolytics
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode462. In this episode, I ll discuss an article about using thrombolysis during resuscitation for out-of-hospital cardiac arrest caused by pulmonary embolism. The post 462: Thrombolytics for out of hospital cardiac arrest appeared first on Pharmacy Joe.
Podcast summary of articles from the October 2019 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include thrombolytics for intermediate risk pulmonary embolism, thrombolytics in cardiac arrest, EMS care in cardiac arrest, sepsis screening scores, nitrous oxide for pain control and board review on Fournier Gangrene. Guest speaker is Dr. Colin Crowe.
In this episode we discuss using thrombolytics for treatment of STEMI when prompt cardiac catheterization is not available. We discuss the risk, benefits, indications, and contraindications of this therapy.
Managing frostbite is both simple and complex. It's been around since human skin met the cold but research within the past few decades and even the past few years has dramatically changed how we care for thermal cold injury. in this episode, frostbite expert and burn surgeon Dr. Anne Wagner discusses frostbite diagnosis, simple and advanced management.
Join the EMGuideWire Team as they discuss the current core concepts of imaging and management of patients with findings concerning for Ischemic CVA (stroke). The EMGuideWire crew is joined by world renowned Emergency Neurology expert, Dr. Andrew Asimos!
“The value of experience is not in seeing much, but in seeing wisely.” ― Sir William Osler Deciphering signal from noise as it relates to modern stroke care can be challenging and conflicting, especially as it pertains to the out of hospital environment. In this podcast, we brought the knowledge and experience of Dr. Ben Newman: a neurosurgeon and endovascular therapy expert to discuss advances, challenges, and strategies in caring for our stroke patients. When to Bypass Perhaps the most challenging decision to make when presented with a patient experiencing an acute stroke is the transport decision. Should we transport them to a Comprehensive Stroke Center (CSC), or to a "thrombolytic capable center"? The 2018 AHA/ASA Stroke Guidelines state that: When several IV alteplase–capable hospital options exist within a defined geographic region, the benefit of bypassing the closest to bring the patient to one that offers a higher level of stroke care, including mechanical thrombectomy, is uncertain. Further research is needed. They also state that the Mission: Lifeline Severity–based Stroke Triage Algorithm for EMS may be reasonable in some circumstances. This algorithm recommends, in some circumstances, transporting the patient to a comprehensive center only if the transport time is "
Beaming out from the NUH DREEAM recording booth comes the second part of the Therapeutics specials on Antithrombotics where our ED Pharmacist Kunal takes us through anticoagulants. We cover the clotting cascade, Heparins, Coumarins, DOACs, Fundoparinux and Thrombolytics. As ever Kunal shares his great knowledge including the reason why warfarin might actually increase your risk of clot! Check out www.takeaurally.com for more information including the Take Visually for this episode. Remember to follow Take Aurally and NUH DREEAM on Facebook and Twitter.
This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM: Thrombolytics for Acute Stroke
This week we discuss a recent study published in the NEJM on low-dose tPA vs standard-dose in acute ischemic stroke. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_53_0_Final_Cut.m4a Download Leave a Comment Tags: Alteplast, CVA, Ischemic Stroke, The ENCHANTED Trial, tPA Show Notes Read More Anderson CS et al. Low-dose versus standard-dose intravenous alteplase in acute ischemic stroke. NEJM 2016. PMID: 27161018 EMNerd: The Case of the Non-Inferior Inferiority Continues REBEL EM: The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke? EMCrit: Podcast 116 – the tPA for Ischemic Stroke Debate EMNerd: A Secondary Examination of the Adventure of the Cardboard Box SMART EM: Thrombolytics for Acute Stroke
In this episode, we will discuss the diagnosis and treatment of stroke and transient ischemic attack (TIA). The ED is the front line in stroke care so we need to know how to work up this chief complaint. We'll go over how to recognize the signs and symptoms of a stroke, how to get a rapid and complete history, how to screen patients for contraindications to thrombolytics, and how to catch a few stroke mimics.
Myocardial Infaction (Part 1): This episode will discuss the diagnosis of MI, STEMI, and non-STEMI. We then discuss the indications and types of thrombolytic agents.