Acute Stroke: From Prehospital Care to In-Hospital Management

Early recognition of stroke by clinical presentation and prehospital stroke assessment tools facilitate rapid prehospital and ED diagnosis. CanStockPhoto/focalpoint   Stroke is a leading cause of morbidity and mortality in the United States and requires prompt recognition by prehospital providers to ensure rapid transport. Stroke can present in a variety of different ways, some more readily apparent than others. Delays in diagnosis and treatment can have devastating effects on the outcomes for these patients. In this article, we describe a patient who initially presented with altered mental status and was subsequently determined to have an acute ischemic stroke. We further review the etiology and pathophysiology of stroke, as well as the prehospital and ED diagnosis and management options available. A case involving a patient who initially presented with concern for altered mental status and was subsequently determined to have had an ischemic stroke is discussed. Prehospital Course Medic 25 was called to a residential address for a 65-year-old male with altered mental status. On arrival, the patient was found to be awake but unable to speak. His wife stated he has hypertension and diabetes, but that he doesn’t like going to the doctor’s office and hasn’t seen his primary care doctor in many years. She reported that after dinner he went to the living room to watch television. When she checked on him 20 minutes later, she found him sitting on the couch and unable t...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news