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Specialty: Emergency Medicine
Condition: Stroke

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Total 1739 results found since Jan 2013.

Validity of a computerised five-level emergency triage system for patients with acute ischaemic stroke
Conclusion Acuity measured by the computerised TTAS demonstrated good validity in facilitating acute care of stroke patients with special regard to thrombolytic therapy.
Source: Emergency Medicine Journal - May 13, 2013 Category: Emergency Medicine Authors: Sung, S.-F., Huang, Y.-C., Ong, C.-T., Chen, W. Tags: Drugs: cardiovascular system, Stroke, Radiology, Adult intensive care, Clinical diagnostic tests Original article Source Type: research

Prevalence and predictors of hospital prealerting in acute stroke: a mixed methods study
Conclusions Up to half of the patients presenting with suspected stroke in this study were prealerted by EMS staff, regardless of eligibility, resulting in disagreements with ED staff during handover. Aligning the expectations of EMS and ED staff, perhaps through simplified prealert protocols, could be considered to facilitate more appropriate use of hospital prealerting in acute stroke.
Source: Emergency Medicine Journal - June 19, 2016 Category: Emergency Medicine Authors: Sheppard, J. P., Lindenmeyer, A., Mellor, R. M., Greenfield, S., Mant, J., Quinn, T., Rosser, A., Sandler, D., Sims, D., Ward, M., McManus, R. J., on behalf of the CLAHRC BBC investigators, on behalf of the CLAHRC BBC investigators, Carr, Helliwell, Nand, Tags: Open access, Stroke, Radiology, Clinical diagnostic tests Prehospital care Source Type: research

Prehospital delay in acute stroke and TIA
Conclusions Severe strokes, use of ambulance and lower age are associated with reduced prehospital delay. The present study shows that more than half of the delay is caused by the hesitation to contact medical services. Public information campaigns should focus on fast symptom recognition and the importance of immediately contacting the Emergency Medical Services upon symptom onset.
Source: Emergency Medicine Journal - July 19, 2013 Category: Emergency Medicine Authors: Faiz, K. W., Sundseth, A., Thommessen, B., Ronning, O. M. Tags: Stroke Original article Source Type: research

Patients' and ambulance service clinicians' experiences of prehospital care for acute myocardial infarction and stroke: a qualitative study
Conclusions Factors that contribute to better patient experience are not necessarily understood in the same way by patients and clinicians. Our findings can contribute to the development of patient experience measures for prehospital care.
Source: Emergency Medicine Journal - October 18, 2013 Category: Emergency Medicine Authors: Togher, F. J., Davy, Z., Siriwardena, A. N. Tags: Drugs: cardiovascular system, Stroke, Acute coronary syndromes, Resuscitation Prehospital care Source Type: research

Reducing delay to stroke thrombolysis--lessons learnt from the Stroke 90 Project
Conclusions The DtoCT pathway was successful in reducing delays to thrombolysis and should be implemented routinely. The call to door and CT to needle times were not improved by our interventions and further work is required to streamline these. Factors beyond the control of most hospitals may play a role in delaying treatment, but local changes can be implemented to mitigate this.
Source: Emergency Medicine Journal - January 20, 2015 Category: Emergency Medicine Authors: Kendall, J., Dutta, D., Brown, E. Tags: Stroke, Radiology, Clinical diagnostic tests, Resuscitation Original article Source Type: research

Risk communication in the hyperacute setting of stroke thrombolysis: an interview study of clinicians
Conclusions Risk communication about thrombolysis involves complex uncertainties. We elucidate the challenges of effective risk communication in a hyperacute setting and identify the issues regarding variation in risk communication and the use of less effective formats for the communication of numerical risks and benefits. The paper identifies good practice, such as the phased transfer of information over the care pathway, and ways in which clinicians might be supported to overcome challenges. This includes standardised risk and benefit information alongside appropriate personalisation of risk communication. Effective risk...
Source: Emergency Medicine Journal - April 18, 2015 Category: Emergency Medicine Authors: Lie, M. L. S., Murtagh, M. J., Watson, D. B., Jenkings, K. N., Mackintosh, J., Ford, G. A., Thomson, R. G. Tags: Stroke, Radiology, Clinical diagnostic tests Original article Source Type: research

Paramedical risk framing during field referral of acute stroke and S-T elevation myocardial infarction patients
Field referral of emergency ambulance patients by paramedics on a widespread basis is a relatively new aspect of paramedicine. Its implementation involves a significant revision to paramedics’ clinical responsibilities and level of interaction with medical specialists. Using grounded theory methodology, this qualitative study uses interviews with paramedics from Ontario, Canada, to explore the framing of risk associated with these referrals in the context of caring for patients with two high-stakes medical conditions: acute stroke and S–T elevation myocardial infarction. The results outline how paramedics have ...
Source: Emergency Medicine Journal - May 18, 2016 Category: Emergency Medicine Authors: Campeau, A. G. Tags: Drugs: cardiovascular system, Stroke, Acute coronary syndromes, Resuscitation Prehospital care Source Type: research

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

A Pediatric and Neonatal Critical Care Transport Team's Standard of Care for Suspected Stroke of a Pediatric Patient
ConclusionThere has been an increase in rapid diagnosis, early recognition and treatment of pediatric patients with acute ischemic stroke and other stroke mimickers that required emergent intervention following implementation of our Stroke Alert Protocol, Clinical Practice Guideline, Suspected Stroke Checklist and tPA Administration and monitoring Guideline for Pediatric and Neonatal Critical Care Transport.
Source: Air Medical Journal - October 13, 2018 Category: Emergency Medicine Source Type: research

Abstract 5: Prevalence, Characteristics, and Accuracy of Stroke Diagnosis for Scene Transports to a Comprehensive Stroke Center by Helicopter Emergency Medical Services: A One Year Retrospective Evaluation
Publication date: July–August 2019Source: Air Medical Journal, Volume 38, Issue 4Author(s): Ekta Panjrolia, Anne Jackson, Stacie Stevens, Lorie Selleck, V. Ramana Feeser, Bert Bogue, Kathy Baker, Harinder DhindsaIschemic strokes affect 795,000 people per year in the US and are a major cause of long-term disability and mortality. These patients are often assessed by EMS at the scene and transported to appropriate centers of care for further evaluation and treatment. Utilization of helicopter emergency medical services (HEMS) greatly improves access to comprehensive stroke centers (CSC). However, the number of patients who...
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Stroke mimics in the pre-hospital setting
Accurate identification of stroke patients is essential to ensure appropriate and timely treatment. Stroke mimics—patients initially suspected to have suffered a stroke who are subsequently diagnosed with a condition other than stroke—are estimated to account for 5–33% of suspected stroke patients conveyed by paramedics to a hospital stroke unit. The prevalence of stroke mimics in London has not been investigated although pan-London hospital data suggests that one quarter of all patients admitted to hyper-acute stroke units (HASUs) are stroke mimics. Participants were recruited as part of a larger study i...
Source: Emergency Medicine Journal - April 18, 2015 Category: Emergency Medicine Authors: Edwards, M. J., Fothergill, R. T., Williams, J., Gompertz, P. Tags: Posters Source Type: research

Ischemic and Hemorrhagic Stroke Among Critically Ill Patients With Coronavirus Disease 2019: An International Multicenter Coronavirus Disease 2019 Critical Care Consortium Study*
CONCLUSIONS: In an international registry of ICU patients with coronavirus disease 2019, stroke was infrequent. Hemorrhagic stroke, but not ischemic stroke, was associated with increased mortality. Further, both hemorrhagic stroke and ischemic stroke were associated with traditional vascular risk factors. Extracorporeal membrane oxygenation use was strongly associated with both stroke and death.
Source: Critical Care Medicine - November 22, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Identification of acute stroke using quantified brain electrical activity.
CONCLUSIONS: Despite a small population and the use of a classifier without the benefit of training on a stroke population, these data suggest that a rapidly acquired, easy-to-use system to assess brain electrical activity at the time of evaluation of acute stroke could be a valuable adjunct to current clinical practice. PMID: 25565489 [PubMed - in process]
Source: Accident and Emergency Nursing - January 1, 2015 Category: Emergency Medicine Authors: Michelson EA, Hanley D, Chabot R, Prichep LS Tags: Acad Emerg Med Source Type: research

Memphis Mobile Stroke Unit Saves Lives
A year after a mobile stroke unit hit the streets of Memphis, officials say it is saving lives by cutting the time it takes to treat stroke patients. The University of Tennessee Health Science Center began using the 14-ton ambulance last year as part of a three-year controlled study. The unit has a CT scanner that can X-ray images of the brain, and is equipped to provide early fluids to stroke patients and dye blood vessels to determine the type of stroke the patient has had. "The emergency room on average takes 40 to 50 minutes to do the things we do in 13 to 14 minutes," said Dr.Andrei Alexandrov, UTHSC neurolo...
Source: JEMS: Journal of Emergency Medical Services News - June 10, 2017 Category: Emergency Medicine Authors: Olivia Peterkin, The Commercial Appeal Tags: News Mobile Integrated Healthcare Source Type: news