Emergency medical services support for acute ischemic stroke patients receiving thrombolysis at a primary stroke center.
Background: Emergency Medical Services (EMS) is a vital link in the overall chain of stroke survival. A Primary Stroke Center (PSC) relies heavily on the 9-1-1 response system along with the ability of EMS personnel to accurately diagnose acute stroke. Other critical elements include identifying tim...
| Publicado en: | Journal of Central Nervous System Disease no. 1; pp. 13 - 18 |
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| Autores principales: | , , , |
| Formato: | pictorial research Journal Article |
| Publicado: |
Sage Publications Inc.
2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105202913&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105202913 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795735 B3L8 jtl: Journal of Central Nervous System Disease issn: 11795735 maglogo: Y pubinfo: dt: 2009 iid: 1 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 105202913 105202913 2010657210 105202913 ppf: 13 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Emergency medical services support for acute ischemic stroke patients receiving thrombolysis at a primary stroke center. aug: au: Spencer BR Khan OM Bobrow BJ Demaerschalk BM affil: Department of Neurology, Mayo Clinic sug: subj: Antifibrinolytic Agents Therapeutic Use Emergency Medical Services Stroke Drug Therapy Aged Blood Glucose Blood Pressure Decision Making, Clinical Descriptive Statistics Early Intervention Emergency Medical Service Communication Systems Female Glasgow Coma Scale Heart Rate Human Male Maps Prehospital Care Prospective Studies Record Review Retrospective Design Scales Stroke Diagnosis Stroke Mortality Tissue Plasminogen Activator Therapeutic Use Transportation of Patients Aged: 65+ years Female Male ab: Background: Emergency Medical Services (EMS) is a vital link in the overall chain of stroke survival. A Primary Stroke Center (PSC) relies heavily on the 9-1-1 response system along with the ability of EMS personnel to accurately diagnose acute stroke. Other critical elements include identifying time of symptom onset, providing pre-hospital care, selecting a destination PSC, and communicating estimated time of arrival (ETA). Purpose: Our purpose was to evaluate the EMS component of thrombolysed acute ischemic stroke patient care at our PSC. Methods: In a retrospective manner we retrieved electronic copies of the EMS incident reports for every thrombolysed ischemic stroke patient treated at our PSC from September 2001 to August 2005. The following data elements were extracted: location of victim, EMS agency, times of dispatch, scene, departure, emergency department (ED) arrival, recordings of time of stroke onset, blood pressure (BP), heart rate (HR), cardiac rhythm, blood glucose (BG), Glasgow Coma Scale (GCS), Cincinnati Stroke Scale (CSS) elements, emergency medical personnel fi eld assessment, and transport decision making. Results: Eighty acute ischemic stroke patients received thrombolysis during the study interval. Eighty-one percent arrived by EMS. Two EMS agencies transported to our PSC. Mean dispatch-to-scene time was 6 min, on-scene time was 16 min, transport time was 10 min. Stroke onset time was recorded in 68%, BP, HR, and cardiac rhythm each in 100%, BG in 81%, GCS in 100%, CSS in 100%, and acute stroke diagnosis was made in 88%. Various diagnostic terms were employed: cerebrovascular accident in 40%, unilateral weakness or numbness in 20%, loss of consciousness in 16%, stroke in 8%, other stroke terms in 4%. In 87% of incident reports there was documentation of decision-making to transport to the nearest PSC in conjunction with pre-notifi cation. Conclusion: The EMS component of thrombolysed acute ischemic stroke patients care at our PSC appeared to be very good overall. Diagnostic accuracy was excellent, fi eld assessment, decision-making, and transport times were very good. There was still room for improvement in documentation of stroke onset and in employment of a common term for acute stroke. pubtype: Academic Journal doctype: pictorial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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