What happened respected doctor Why no videos, doctor iam regularly watching ur videos, ur videos is inspiration for health care profesionals,love u lot from the bottom of my heart
Sir One question Sir i am a nurse and work in ER department One patient came and he was gasping Spo2 -30% on RA Bp -160/100 mmhg K/c/o - PTCA with HTN with EF (30-35)% But the duty doctor advised to connect Bipap to patient, and just after few seconds pt condition deteriorated, and he died Was putting the patient on bipap was right, if yes what’s the rationale?? And what was the reason for giving Norad when the patient bp was on higher side ?
Sir, kindly correct -FLAIR / DWI mismatch is not for thrombolysis but for consideration for mechanical thrombectomy. And acute infarct appears hyperintense on diffusion and not hypodense.
You can IVT, A meta-analysis pooled individual patient data (n = 414) from three trials (EXTEND, ECASS 4, and EPITHET) of intravenous alteplase that used imaging to identify and treat patients with salvageable brain tissue who had ischemic stroke 4.5 to 9 hours after onset or had wake-up stroke [15]. There was a higher rate of excellent functional outcome (defined by a mRS score 0 of 1) at three months for patients assigned to alteplase compared with those assigned to placebo (36 versus 29 percent, adjusted odds ratio [OR] 1.86, 95% CI 1.15-2.99). Symptomatic intracerebral hemorrhage was more frequent in the alteplase group (5 versus 0.5 percent), but this result did not nullify the overall benefit of alteplase. Limitations to this meta-analysis include small sample size and early stopping of two of the included trials (EXTEND and ECASS 4). Another meta-analysis of four trials (including Wake-Up Stroke, EXTEND, and ECASS 4) with individual patient data from over 843 patients reported similar findings [16]. Although this approach seems promising, additional trials are needed to confirm the efficacy and safety of IVT using imaging selection of patients with a stroke onset time >4.5 hours or an unknown stroke onset time [17]. Advanced imaging with MRI (DWI and FLAIR), MRI perfusion, or CT perfusion appears to be essential to determine if the cerebral infarction is recent and if there is significant salvageable brain tissue. Results of the TWIST trial suggest that selecting patients with noncontrast head CT alone (to exclude hemorrhage or large infarction) is unlikely to identify patients with wake-up stroke who will benefit from IVT and yes its hyperdensity / restricted diffusion. thank you.
Long live sir ! ❤
I wish I saw your channel earlier . useful one of the best videos I can watch , short and precise, can watch during busy schedules
What happened respected doctor
Why no videos, doctor iam regularly watching ur videos, ur videos is inspiration for health care profesionals,love u lot from the bottom of my heart
From July , will be back . Was busy in backend activities and updates since last 2 months .
Very interesting and informative
Sir plz discuss abt barbiturate coma dose in status epilepticus
Explain DW, flair in detail... what is the mechanism of uptake or interpretation with infarct or hemorrhage
Sir which vasodilator is good for post up laparotomy persistent hypertension?
Sir
One question
Sir i am a nurse and work in ER department
One patient came and he was gasping
Spo2 -30% on RA
Bp -160/100 mmhg
K/c/o - PTCA with HTN with EF (30-35)%
But the duty doctor advised to connect Bipap to patient, and just after few seconds
pt condition deteriorated, and he died
Was putting the patient on bipap was right, if yes what’s the rationale??
And what was the reason for giving Norad when the patient bp was on higher side ?
Sir, kindly correct -FLAIR / DWI mismatch is not for thrombolysis but for consideration for mechanical thrombectomy. And acute infarct appears hyperintense on diffusion and not hypodense.
You can IVT,
A meta-analysis pooled individual patient data (n = 414) from three trials (EXTEND, ECASS 4, and EPITHET) of intravenous alteplase that used imaging to identify and treat patients with salvageable brain tissue who had ischemic stroke 4.5 to 9 hours after onset or had wake-up stroke [15]. There was a higher rate of excellent functional outcome (defined by a mRS score 0 of 1) at three months for patients assigned to alteplase compared with those assigned to placebo (36 versus 29 percent, adjusted odds ratio [OR] 1.86, 95% CI 1.15-2.99). Symptomatic intracerebral hemorrhage was more frequent in the alteplase group (5 versus 0.5 percent), but this result did not nullify the overall benefit of alteplase. Limitations to this meta-analysis include small sample size and early stopping of two of the included trials (EXTEND and ECASS 4). Another meta-analysis of four trials (including Wake-Up Stroke, EXTEND, and ECASS 4) with individual patient data from over 843 patients reported similar findings [16].
Although this approach seems promising, additional trials are needed to confirm the efficacy and safety of IVT using imaging selection of patients with a stroke onset time >4.5 hours or an unknown stroke onset time [17]. Advanced imaging with MRI (DWI and FLAIR), MRI perfusion, or CT perfusion appears to be essential to determine if the cerebral infarction is recent and if there is significant salvageable brain tissue. Results of the TWIST trial suggest that selecting patients with noncontrast head CT alone (to exclude hemorrhage or large infarction) is unlikely to identify patients with wake-up stroke who will benefit from IVT
and yes its hyperdensity / restricted diffusion. thank you.