Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates

Kelly, Kathleen; Holt, Kathryn T.; Neshewat, Gina M.; Skolarus, Lesli E.

doi:10.1007/s11883-017-0695-5

Cited by 11 publications

(6 citation statements)

References 49 publications

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“…Acute stroke (AS) is an acute cerebrovascular disease and is caused by the sudden rupture of blood vessels in the brain or the insufficiency of blood flow into the brain due to vascular obstruction, with high morbidity, disability, and mortality [ 1 , 2 ]. The goal of the AS treatment is to minimize functional disorders, restore limb function and cognitive ability, prevent complications, and enhance the patients' prognosis [ 3 , 4 ]. Therefore, effective nursing regimens are of great significance to lower the disability rate and improve the quality of life of patients.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Multidisciplinary Nursing Based on Fever, Blood Sugar, and Swallowing Function Management in Patients with Acute Stroke

2022

Evidence-Based Complementary and Alternative Medicine

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Purpose. The aim of this study was to assess the effectiveness of multidisciplinary nursing based on fever, blood sugar, and swallowing function management in patients with acute stroke (AS). Methods. A total of 200 AS patients who were treated in our hospital from January 2016 to January 2020 were recruited and randomized at a ratio of 1 : 1 into a control group and a study group. The control group received standardized early rehabilitation nursing, and the study group received multidisciplinary nursing based on fever, blood sugar, and swallowing function management plus standardized early rehabilitation nursing. The patients were also assigned different blood glucose levels upon admission to a high blood glucose group or a normal blood glucose group. The clinical endpoint is clinical efficacy. Results. Multidisciplinary nursing resulted in better clinical outcomes and treatment efficiency in the patients in the study group versus standardized early rehabilitation nursing. When compared with the control group, the patients in the study group showed lower National Institute of Health Stroke Scale (NIHSS) scores, higher Barthel Index (BI) scores, lower fasting blood glucose levels and body temperature 24 hours after admission, a lower incidence of swallowing dysfunction and aspiration pneumonia 30 days after nursing, and lower C-reactive Protein (CRP) levels 7 days after nursing. The NIHSS scores of the high blood glucose group were significantly higher than those of the normal blood glucose group. Conclusion. Multidisciplinary nursing based on fever, blood sugar, and swallowing function management for patients with AS improves the clinical outcome and treatment efficiency, restores the swallowing function and blood glucose level, and ameliorates the long-term prognosis of patients.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of Multidisciplinary Nursing Based on Fever, Blood Sugar, and Swallowing Function Management in Patients with Acute Stroke

2022

Evidence-Based Complementary and Alternative Medicine

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“…The TCD data were collected during the time between patient treatment and did not impact patient care. Computed tomography angiography (CTA) examinations were performed (1) using a GE Lightspeed VCT 64-section multidetector scanner (GE Healthcare, Milwaukee, Wisconsin) with a slice thickness of 0.625 mm, and bolus injection of 70 mL of Omnipaque 350 (GE Healthcare) contrast material (4.0 mL/s). CTA images were reformatted in the coronal and sagittal plane, and 10-mm maximum intensity projection reconstructions were rendered for review.…”

Section: Methodsmentioning

confidence: 99%

“…Despite efforts in education and training, the identification of large vessel occlusions (LVO) in the acute stage is still a significant problem. 1 In a pathology where time to treatment is the most important factor in patient outcome, 2 tools that provide complementary diagnostic information are vitally important. 3 Recently, the potential utility of transcranial Doppler (TCD) ultrasound in the acute setting was presented in Thorpe et al 4 In addition to the subjective evaluation of the TCD waveform, 5 that work presented an objective quantification of waveform morphology designated velocity curvature index (VCI).…”

Section: Introductionmentioning

confidence: 99%

A Case Study on the Utility of Transcranial Doppler Ultrasound in Acute Stroke Evaluation

Thibeault

Dorn

Thorpe

et al. 2019

Journal for Vascular Ultrasound

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The use of transcranial Doppler (TCD) ultrasound in the acute stage of large vessel occlusion diagnosis has, for a number of reasons, not seen widespread adoption. The high temporal fidelity of TCD provides information about the neurovasculature that neurological tests and standard computed tomography (CT) imaging cannot. This presents an opportunity in the early evaluation of patients that can help clinicians make informed decisions. The case study presented here illustrates the complementary information that TCD can provide in a situation where other available tests failed to fully elucidate the underlying pathology.

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“…One possible means of decreasing prehospital delay is to increase stroke preparedness in the general population; however, previous studies of this topic have shown mixed results ( 9 – 11 ). Another method is to educate paramedics in stroke signs recognition.…”

Section: Introductionmentioning

confidence: 99%

New Prehospital Triage for Stroke Patients Significantly Reduces Transport Time of EVT Patients Without Delaying IVT

et al. 2021

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Background and Purpose: Ischemic stroke is a leading cause of mortality and morbidity worldwide. The time from stroke onset to treatment impacts clinical outcome. Here, we examined whether changing a triage model from “drip and ship” to “mothership” yielded significant reductions of onset-to-groin time (OGT) in patients receiving EVT and onset-to-needle time (ONT) in IVT-treated patients, compared to before FAST-PLUS test implementation. We also investigated whether the new triage improved clinical outcomes.Methods: In a before/after multicenter study, we evaluated the effects of changing the prehospital triage system for suspected stroke patients in the Moravian–Silesian region, Czech Republic. In the new system, the validated FAST PLUS test is used to differentiate patients with suspected large vessel occlusion and triage-positive patients are transported directly to the CSC. Time metrics and patient data were obtained from the regional EMS database and SITS database.Results: For EVT patients, the median OGT was 213 min in 2015 and 142 min in 2018, and the median TT was 142 min in 2015 and 47 min in 2018. For tPA patients, the median ONT was 110 min in 2015 and 109 min in 2018, and the median TT was 41 min in 2015 and 48 min in 2018. Clinical outcome did not significantly change. The percentages of patients with favorable clinical outcome (mRS 0–2) were comparable between 2015 and 2018: 60 vs. 59% in tPA patients and 40 vs. 44% in EVT patients.Conclusions: The new prehospital triage has yielded shorter OGTs for EVT patients. No changes were found in the onset-to-needle time for IVT-treated patients, or in the clinical outcome at 3 months after stroke onset.

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Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates

Cited by 11 publications

References 49 publications

Effectiveness of Multidisciplinary Nursing Based on Fever, Blood Sugar, and Swallowing Function Management in Patients with Acute Stroke

Effectiveness of Multidisciplinary Nursing Based on Fever, Blood Sugar, and Swallowing Function Management in Patients with Acute Stroke

A Case Study on the Utility of Transcranial Doppler Ultrasound in Acute Stroke Evaluation

New Prehospital Triage for Stroke Patients Significantly Reduces Transport Time of EVT Patients Without Delaying IVT

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