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Specialty: Emergency Medicine
Condition: Stroke

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Total 1739 results found since Jan 2013.

Stroke severity quantification by critical care physicians in a mobile stroke unit
Conclusion Critical care physicians in a mobile stroke unit may use the NIHSS as a clinical tool in the assessment of patients experiencing acute stroke. The disagreement in NIHSS scores was mainly for very low values and would not have changed the handling of the patients.
Source: European Journal of Emergency Medicine - May 1, 2019 Category: Emergency Medicine Tags: Original articles Source Type: research

Wake-up Stroke: New Opportunities for Acute Stroke Treatment
AbstractPurposeThis review summarizes the current science underpinning the treatment of patients with ischemic stroke who awaken with stroke symptoms. This large subset of stroke patients has historically been precluded from treatment with disability-limiting reperfusion therapies such as intravenous thrombolysis. Recent advances in neuroimaging have shifted the paradigm of treatment based upon rigid time-based criteria to treatment guided by evidence of salvageable ischemic penumbra on advanced imaging.Recent FindingsSeveral recent randomized controlled trials provide evidence that imaging-guided treatment of wake-up and ...
Source: Current Emergency and Hospital Medicine Reports - January 9, 2020 Category: Emergency Medicine Source Type: research

Emergency department utilization after hospitalization discharge for acute stroke: The COMprehensive Post-Acute Stroke Services (COMPASS) study
We examined data from the Comprehensive Post-Acute Stroke Services (COMPASS) study, a cluster-randomized pragmatic trial of a post-discharge transitional care model for stroke survivors and their caregivers compared with usual care.3,4.PMID:34657341 | DOI:10.1111/acem.14401
Source: Accident and Emergency Nursing - October 17, 2021 Category: Emergency Medicine Authors: Wayne D Rosamond Anna M Kucharska-Newton Sara B Jones Matthew A Psioda Barbara J Lutz Anna M Johnson Sylvia W Coleman Samantha R Schilsky Mehul D Patel Pamela W Duncan Source Type: research

Factors associated with delayed revascularization in patients with ischemic stroke: a prospective study in one French region
Conclusion This study shows that efforts to organize the care chain for stroke need to be intensified in the region to reduce treatment time intervals, which could include information campaigns focused on the impact of EMS call and the clinical presentation recognition.
Source: European Journal of Emergency Medicine - December 24, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comparison of Arterial Ischemic and Hemorrhagic Pediatric Stroke in Etiology, Risk Factors, Clinical Manifestations, and Prognosis
Conclusions Moyamoya disease/syndrome and arteriovenous malformation rapture are the most common cause of AIS and HS, respectively. Iron deficiency anemia was commonly found in childhood AIS. The time to diagnosis in both AIS and HS was delayed. The mortality rate in HS was higher than in AIS. Neurological deficits are seen in 70% of childhood AIS during the follow-up. One-third of the children in our study developed epilepsy, which generally responds to a single antiseizure medication. The recurrence rate of childhood stroke was low compared with adult stroke.
Source: Pediatric Emergency Care - September 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Prehospital stroke diagnosis and treatment in ambulances and helicopters—a concept paper
Abstract: Stroke is the second common cause of death and the primary cause of early invalidity worldwide. Different from other diseases is the time sensitivity related to stroke. In case of an ischemic event occluding a brain artery, 2000000 neurons die every minute. Stroke diagnosis and treatment should be initiated at the earliest time point possible, preferably at the site or during patient transport. Portable ultrasound has been used for prehospital diagnosis for applications other than stroke, and its acceptance as a valuable diagnostic tool “in the field” is growing. The intrahospital use of transcranial ultrasou...
Source: The American Journal of Emergency Medicine - February 14, 2013 Category: Emergency Medicine Authors: Thilo Hölscher, James V. Dunford, Felix Schlachetzki, Sandra Boy, Thomas Hemmen, Brett C. Meyer, John Serra, Jeff Powers, Arne Voie Tags: Reviews Source Type: research

The accuracy of surrogate decision makers: informed consent in hypothetical acute stroke scenarios
Conclusions: Surrogates accurately predict patient preferences for standard acute stroke treatments. However, the accuracy decreases when predicting research participation suggesting that the degree of surrogate agreement is dependent on the type of decision being made. Further research is needed to more thoroughly characterize surrogate decision-making in acute stroke situations.
Source: BMC Emergency Medicine - November 13, 2013 Category: Emergency Medicine Authors: Jessica BryantLesli SkolarusBarbara SmithEric AdelmanWilliam Meurer Source Type: research

Optimized acute stroke pathway using medical advanced regulation for stroke and repeated public awareness campaigns
Conclusion: Educational programs repeated each year are useful to the population for learning how to recognize stroke symptoms and send straight away an emergency call. Combining the emergency action with an early remote evaluation by the stroke center team and a direct admission in imaging department shortens the time-to-treatment delay. This model is reproducible in different health care systems.
Source: The American Journal of Emergency Medicine - November 18, 2013 Category: Emergency Medicine Authors: Valéry Soulleihet, François Nicoli, Jacques Trouve, Nadine Girard, Laurent Jacquin Tags: Original Contributions Source Type: research

Views of Paramedics on Their Role in an Out-of-Hospital Ambulance-Based Trial in Ultra-Acute Stroke: Qualitative Data From the Rapid Intervention With Glyceryl Trinitrate in Hypertensive Stroke Trial (RIGHT)
Conclusion Ultra-acute stroke research in the out-of-hospital environment is feasible, but important barriers need to be addressed. Proxy consent by paramedics addresses some of the difficulties with the consent process in the out-of-hospital setting.
Source: Annals of Emergency Medicine - November 24, 2014 Category: Emergency Medicine Source Type: research

Neurologic emergencies in resource-limited settings: A review of stroke care considerations
Publication date: Available online 13 October 2014 Source:African Journal of Emergency Medicine Author(s): Bret Nicks , Jackson Henley , Juma Mfinanga , David Manthey Background The current guidelines and evidence supporting acute stroke management have limitations in resource austere environments despite being a leading cause of death worldwide. Developing countries face a rapidly increasing and disproportionate burden of cerebrovascular disease yet differences in setting and resource limitations bring challenges that have a major influence in management options – especially with routine imaging and interventional con...
Source: African Journal of Emergency Medicine - December 18, 2014 Category: Emergency Medicine Source Type: research

Race and Sex Disparities in Prehospital Recognition of Acute Stroke
ConclusionsSignificant disparities exist in prehospital stroke recognition.
Source: Academic Emergency Medicine - February 25, 2015 Category: Emergency Medicine Authors: Prasanthi Govindarajan, Benjamin T. Friedman, James Q. Delgadillo, David Ghilarducci, Lawrence J. Cook, Barbara Grimes, Charles E. McCulloch, S. Claiborne Johnston Tags: Original Contribution Source Type: research

Patient characteristics affecting stroke identification by emergency medical service providers in Brooklyn, New York
This study aims to identify patient characteristics that affect prehospital identification of stroke by Long Island college hospital (LICH) emergency medical services (EMS). All suspected strokes brought to LICH by LICH ambulances from January 1, 2010 to December 31, 2011 were included in the study. We compared prehospital care report-based diagnosis against the get with the guidelines (GWTG) database. Age-adjusted logistic regression models were used to study that the effect of individual patient characteristics have on EMS providers’ diagnosis. Included in the study were 10,384 patients with mean age 43.9 years. Of wh...
Source: Internal and Emergency Medicine - November 9, 2015 Category: Emergency Medicine Source Type: research

Emergency medical services transport delays for suspected stroke and myocardial infarction patients
Conclusion: In this study, prehospital delays, as measured by total transport time exceeding guideline was influenced by season, EMS agency responsible, patient age and whether or not the patient is transported to a specialty center. The magnitude of the delays associated with some of the factors are large enough to be clinically important although others, though statistically significant, may not be large enough to be clinically important. These findings should be useful for guiding future studies and local health initiatives that seek to reduce disparities in prehospital delays so as to improve health services and outcom...
Source: BMC Emergency Medicine - December 3, 2015 Category: Emergency Medicine Authors: Ashley GoldenAgricola Odoi Source Type: research

Potentially Missed Diagnosis of Ischemic Stroke in the Emergency Department in the Greater Cincinnati/Northern Kentucky Stroke Study.
CONCLUSION: In a large population-based sample of AIS cases, 1 in 7 cases were not diagnosed as AIS in the ED, but the impact on acute treatment rates is likely small. Missed diagnosis was more common among those with decreased LOC, suggesting the need for improved diagnostic approaches in these patients. This article is protected by copyright. All rights reserved. PMID: 27313141 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - June 16, 2016 Category: Emergency Medicine Authors: Madsen TE, Khoury J, Cadena R, Adeoye O, Alwell KA, Moomaw CJ, McDonough E, Flaherty ML, Ferioli S, Woo D, Khatri P, Broderick JP, Kissela BM, Kleindorfer D Tags: Acad Emerg Med Source Type: research

Prehospital Ultrasound Proves its Worth in the War Against Stroke
Discussion Stroke is a devastating neurologic condition with an alarming prevalence. Each year, an estimated 795,000 people in the United States alone will suffer a stroke. Stroke accounts for one in every 20 deaths in the U.S., and someone dies of stroke in the U.S. every four minutes.1 One third of people who have had a stroke will be left with some degree of long-term disability.2 Eighty-seven percent of all strokes are ischemic, meaning that a clot or other occlusion to blood flow forms within an intracranial vessel, depriving the brain tissue of blood flow.1 If this obstruction isn't rapidly relieved, damage to the brain will occur.
Source: JEMS Patient Care - December 1, 2016 Category: Emergency Medicine Authors: Jenna M. B. White, MD Tags: Patient Care Source Type: news