Ischemic Stroke - Hennepin County Medical Center

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Dear Readers: As an emergency physician, I know that my practice is more successful when I try to evolve with medical advances and partner with the outstanding multidisciplinary team at Hennepin. The question I and most other clinicians often ask is: how? How can I keep better track of medical advances and apply what I’ve learned to my practice? How can I better partner with and understand the perspectives of the multiple disciplines on each critical care patient’s team? Approaches in Critical Care is our attempt to provide an answer those questions. In Approaches in Critical Care, you’ll find real-life critical care challenges, chosen because of the lessons they offer for everyday clinical practice and written to be relevant to multiple critical care disciplines, including physician specialists, subspecialists, emergency medical services (EMS), nurses, and others. Each issue will include a special section for EMS professionals, a profile of a clinician who can lend perspective on the topic being highlighted, and information on recent news and events. The theme of this inaugural issue is ischemic stroke care. Soon we’ll begin work our Spring 2009 issue, which will be devoted to trauma care. Have you had an interesting recent trauma case from which others could learn? If so, consider authoring a case report. For more information, see the author’s guidelines on our Web site at www.hcmc.org/approaches. Or if you have an idea for improving this publication, please contact us. Like good medicine, we hope this publication continually evolves with the needs of all the disciplines involved in treating the critical care patient. Sincerely, Michelle H. Biros, MD, MS Department of Emergency Medicine Hennepin County Medical Center ®
Contents Volume 1 | Approaches in Critical Care December 2008 Approaches in Critical Care Editor-in-Chief Michelle Biros, MD, MS Managing Editor Linda Zespy EMS Perspectives Editor Robert Ball, EMT-P Graphic Designer Karen Olson Marketing Director Ted Blank Patient Care Director, Critical Care and Emergency Services Kendall Hicks, RN Patient Care Director, Behavioral and Rehabilitative Services Joanne Hall, RN Printer Sexton Printing Photographers Raoul Benavides Clinical Reviewer Robert Taylor, MD Case Reports 2 Management of middle cerebral stroke with mass effect in the setting of heparin-induced thrombocytopenia Charles Bruen, MD 6 Management of an ischemic stroke with delayed clinical deterioration, using intra-arterial tPA and angioplasty Jeremy Olson, MD 8 A case of delayed intra-arterial thrombolysis in a cerebrovascular accident Lisa M. Hayden, MD 11 Critical Care Profile Adnan Qureshi, MD, Executive Director of the Minnesota Stroke Initiative 13 EMS Perspectives History, prehospital assessment, and management of acute stroke 17 Calendar of Events 19 News Notes To submit an article Contact Managing Editor Linda Zespy at approaches@hcmed.org. The editors reserve the right to reject editorial or scientific materials for publication in Approaches in Critical Care. The views expressed in this journal do not necessarily represent those of Hennepin County Medical Center, its editors, or its staff members. Copyright Copyright 2008 Hennepin County Medical Center. Approaches in Critical Care is published twice per year by Hennepin County Medical Center, 701 Park Avenue, Minneapolis, Minnesota 55415. Subscriptions To subscribe, send an email to approaches@hcmed.org with your name and full mailing address. Approaches in Critical Care | December 2008 | 1
Page 4 and 5: Case Reports Treating Ischemic Stro
Page 6 and 7: Case Reports She is continent of bo
Page 8 and 9: Case Reports Case Two Management of
Page 10 and 11: Case Reports Figure One. Head CT pe
Page 12 and 13: Case Reports Since this patient suf
Page 14 and 15: Profiles in Critical Care You are t
Page 16 and 17: EMS Perspectives time from a mere 3
Page 18 and 19: EMS Perspectives __________________
Page 20 and 21: Calendar of Events December 2008 De
Page 22 and 23: News Notes Team releases data on st
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Ischemic Stroke - Hennepin County Medical Center

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