Blood Pressure Management Following Acute Ischemic Stroke: A Review of Primary Literature.

Elevated blood pressure is common in patients with acute ischemic stroke. While this may occur secondary to the body's own response to preserve cerebral blood flow, elevated blood pressure may also increase the risk of hemorrhagic transformation. Current guidelines recommend various blood pressure goals based upon multiple factors, including thresholds specific to certain treatment interventions. Despite these guidelines, there is limited evidence to support specific blood pressure targets, and variability in clinical practice is common. The purpose of this review was to discuss blood pressure management in adult patients with acute ischemic stroke, focusing on appropriate targets in the setting of alteplase administration, mechanical thrombectomy, and hemorrhagic transformation.

Variability in training, practice, and prioritization of services among emergency medicine pharmacists.

PURPOSE: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. METHODS: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics. Pharmacists were asked to define the frequency with which they performed ASHP-identified best practice services. RESULTS: Responses were received by 208 pharmacists (response rate = 9.4%) who were primarily from academic (48.1%) or community (47.6%) emergency departments (EDs). Pharmacists working in an academic ED were more likely to have EM postgraduate year 2 training (27.8%) compared to a community ED (11.2%) (p = 0.0182). Pharmacists practicing in an academic emergency department (ED) reported participating in traumas, care for boarded patients, and performing scholarly activities more frequently (p < 0.01) and medication reconciliations less frequently (p < 0.01) than those in a community ED. Most EM pharmacists reported postgraduate year 1 training (45.7%) as compared to postgraduate year 2 EM (18.3%) or critical care (13.7%) pharmacy residency training. CONCLUSION: Institution and ED demographics as well as pharmacist level of training can affect the frequency of services provided in the ED setting.

Review of Grit and Resilience Literature within Health Professions Education.

Objective. To review literature pertaining to grit and resilience in health professions education. Findings. There is significant interest in grit and resilience throughout the health professions, but little has been published with regard to pharmacy. Although there are methodological issues with defining and measuring grit and resilience, several studies have shown relationships between the constructs and personal and academic well-being. Educational interventions aimed at increasing grit and resilience have produced mixed results. Developing protective factors appears to be the most common approach in helping students become more resilient. Summary. Literature pertaining to grit and resilience reveals that the terms are nuanced, complex, and difficult to measure and understand. Regardless, the general characteristics associated with grit and resilience are of interest to educators and warrant further study.