The American journal of emergency medicine
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Intravenous thrombolysis remains the primary treatment for acute ischemic stroke (AIS); however, administration is time sensitive. Teleneurology services have increased in popularity in recent years due to their ability to aid in triaging patients with neurological conditions. Teleneurology services were implemented at this comprehensive stroke center, in August 2023 to aid in streamlining the administration of tenecteplase in AIS patients. Currently, there are no studies assessing whether the implementation of teleneurology services at a comprehensive stroke center influences tenecteplase door-to-needle time. The purpose of this study is to evaluate the difference in door-to-needle times when tenecteplase is administered with versus without a teleneurology consult. ⋯ Among patients who received tenecteplase for the treatment of AIS, there was a significant reduction in door-to-needle time with the use of teleneurology services. There was no difference in neurological improvement or rate of hemorrhagic conversion.
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Posterior hip dislocation is commonly seen in the emergency department and requires urgent reduction to help avoid complications. Many techniques have been described to perform the reduction, all aimed at helping the physician gain a mechanical advantage to overcome the bony anatomy and large muscles groups involved. ⋯ The lift is engaged to create the desired traction, allowing the provider to manipulate the hip with adduction/abduction and/or internal/external rotation to achieve reduction. In addition, our method may also allow the provider to task switch more easily between other requirements, such as procedural sedation and attention to the patient's airway, especially in the single coverage emergency department.