Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Heikkilä, Iiro; Kuusisto, Hanna; Stolberg, Alexandr; Palomäki, Ari

doi:10.1186/s13049-016-0237-0

Cited by 18 publications

(33 citation statements)

References 22 publications

(28 reference statements)

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“…A previous study further demonstrated that the image-to-needle time could be a more common contributor to a delay in timely thrombolytic therapy [37]. Therefore, improving the competency of stroke image interpretation of MS and PC physicians should also play an important role in the quality of AIS care [38].…”

Section: Discussionmentioning

confidence: 99%

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

et al. 2019

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Background Few systematic methods prioritize the image education in medical students (MS). We hope to develop a checklist of brain computerized tomography (CT) reading in patients with suspected acute ischemic stroke (AIS) for MS and primary care (PC) physicians. Methods Our pilot group generated the items indicating specific structures or signs for the checklist of brain CT reading in suspected AIS patients for MS and PC physicians. These items were used in a modified web-based Delphi process using the online software “SurveyMonkey”. In total 15 panelists including neurologists, neurosurgeons, neuroradiologists, and emergency department physicians participated in the modified Delphi process. Each panelist was encouraged to express feedback, agreement or disagreement on the inclusion of each item using a 9-point Likert scale. Items with median scores of 7–9 were included in our final checklist. Results Fifty-two items were initially provided for the first round of the Delphi process. Of these, 35 achieved general agreement of being an essential item for the MS and PC physicians. The other 17 of the 52 items in this round and another two added items suggested by the panelists were further rated in the next round. Finally, 38 items were included in the essential checklist items of brain CT reading in suspected AIS patients for MS and PC physicians. Conclusions We established a reference regarding the essential items of brain CT reading in suspected AIS patients. We hope this helps to minimize malpractice and a delayed diagnosis, and to improve competency-based medical education for MS and PC physicians.

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Section: Discussionmentioning

confidence: 99%

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

et al. 2019

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“…in Finland found that their median DTN time in 2012 was 54 min (our current mean time) which was reduced to 28 min to 2013. [ 22 ] Thus, we still have scope for more improvement and efforts are on to further reduce DTN times at our hospital. The mean duration of DTN time in our study was found to be 54 min.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the effective management of acute stroke: A prospective observational study

Nagendra

Kumar

Bohra

et al. 2018

Indian Journal of Critical Care Medicine

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Background:Stroke, characterized by sudden loss of cerebral function, is among one of the leading cause of death and disability world over. The newer treatment modalities have changed the landscape of stroke treatment but are very much time bound.Aim:To characterize pre-hospital and in-hospital factors affecting acute stroke management thus defining lacunae in stroke management.Subjects and Methods:A prospective observational study, conducted at the emergency department of a tertiary care center in southern India from August 2015 to July 2016. All stroke patients presenting within first 24 hours of onset were included. A pre -defined Knowledge-Attitude-Practice (KAP) questionnaire was used.Results:Total of 133 patients were eligible out of which 28 were excluded for various reasons. Majority were >60 years age and male (61%). About 60% arrived within window. Distance from the hospital was one of the major factors for arrival within the window period. When compared by KAP questionnaire, bystanders of those arriving within window period had better awareness of stroke symptoms.Conclusions:Improving awareness of stroke symptoms and increasing availability of EMS is likely increase chances of stroke patients receiving appropriate acute management.

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“…Emergency medicine was recognized as an independent speciality in Finland in 2013 [6]. When initiating practical training in this speciality in our emergency department (ED), we implemented a new treatment protocol for acute ischaemic stroke [7]. The protocol is activated on pre-notification by the emergency medical services (EMS), although some AIS patients may arrive by other means.…”

Section: Introductionmentioning

confidence: 99%

Short door-in-door-out time of stroke patients in need of thrombectomy in a primary stroke centre

2021

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COVID-19 epidemic has had a negative effect on the resources of emergency departments. While the number of acute ischaemic stroke (AIS) patients eligible for reperfusion therapies has decreased in the emergency departments (EDs), times to thrombolytic and endovascular treatments of AIS patients have become longer. In this paper, we report an ultra-fast diagnostic protocol in the settings of AIS in the ED of a primary stroke centre. Experiences using case studies of three patients have also been provided. Patients treated in accordance with the protocol received primary diagnoses and endovascular treatment with door-in-door-out times of 15 to 21 minutes.

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Stroke thrombolysis given by emergency physicians cuts in-hospital delays significantly immediately after implementing a new treatment protocol

Cited by 18 publications

References 22 publications

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

Factors affecting the effective management of acute stroke: A prospective observational study

Short door-in-door-out time of stroke patients in need of thrombectomy in a primary stroke centre

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