Background and Purpose-Community stroke screening is a commonly used prevention strategy to identify and educate those at risk. Although the goal of this approach is to reduce the overall occurrence of stroke, its long-term benefit remains unknown. The purpose of this study was to determine whether attendance of a stroke screening changes knowledge or prevention practices in persons at risk for stroke 3 months later. Methods-A stroke screening event was held following the National Stroke Association guidelines, with health screening, counseling, and education. Knowledge about stroke was measured by a questionnaire before and after the event. At 3 months, attendees identified at risk for stroke were contacted by telephone to determine their retained knowledge and any specific actions taken as a result of the health counseling. Results-At 3 months, 78 persons were contacted. Knowledge of stroke warning signs increased from 59% to 94% after screening but decreased to 77% at 3 months. At 3 months, 73% had done nothing to change their health practices. Conclusions-Community stroke screening has modest effects on health behavior, knowledge of stroke risk factors, and warning signs. (Stroke. 2003;34:e247-e249.)Key Words: education Ⅲ prevention Ⅲ risk factors Ⅲ screening Ⅲ stroke I mproving community knowledge of stroke risk factors and stroke symptoms is a critical factor in improving access to preventative stroke treatments and acute stroke intervention. Recent efforts to educate the public have increased knowledge of warning signs but did not significantly improve risk factor recognition. 1 Community stroke screenings are a commonly used strategy to improve recognition of stroke warning signs and risk factors, but their benefits in changing health behaviors remain unknown. The goal of this study was to determine whether attendance of a stroke screening changes knowledge or prevention practices in persons at risk for stroke 3 months later. Subjects and MethodsSubjects consisted of a convenience sample of participants who attended an advertised community stroke screening conducted in the spring of 2000. Funding for the screening program was provided by an unrestricted educational grant from the National Stroke Association and Bristol-Myers Squibb. Human subjects approval was granted by the sponsor agency, Mercy Healthcare Sacramento and California State University Sacramento.The screening program followed the guidelines and format for stroke screening recommended by the National Stroke Association (NSA). 2 Participants completed the NSA self-risk assessment that detailed knowledge of stroke, medical history, lifestyle, and current prevention practices. The participants who consented to participate in the follow-up study supplied a contact number for follow-up.Healthcare professionals manned screening stations for blood pressure measurement, carotid bruit detection, cholesterol measurement, and atrial fibrillation screening.Blood pressure was measured by a registered nurse using the Omron automatic blood pressure cuff. ...

Background: The 3-hour window for treating stroke with intravenous tissue plasminogen activator (t-PA) requires well-organized, integrated efforts by emergency physicians and stroke neurologists.

Background Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings. Methods Data on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage. Results Complete data were available on 33 patients with Hunt-Hess grade IV–V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 days (mean, 19 days; range, 4–64 days). One patient (3%) had deep vein thrombosis in an upper extremity. In 2 patients, central venous pressure measured with a peripherally inserted catheter was higher than pressure measured concurrently with a central venous catheter. None of the 33 patients had a central catheter bloodstream infection or persistent insertion-related complications. Conclusions Use of peripherally inserted central catheters rather than central venous catheters or pulmonary artery catheters in the neurocritical care unit reduced procedural and infection risk without compromising patient management.