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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 Assessment of the Acute Stroke Diagnostic Process Using Failure Modes, Effects, and Criticality Analysis
CONCLUSION: Our study results highlight the critical importance of upstream steps in the acute stroke diagnostic process, particularly the use of existing tools to identify stroke patients who may be eligible for time-sensitive treatments.PMID:36565234 | DOI:10.1111/acem.14648
Source: Accident and Emergency Nursing - December 24, 2022 Category: Emergency Medicine Authors: Ava L Liberman Jane L Holl Elida Romo Matthew Maas Sarah Song Shyam Prabhakaran 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

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

Chicago's Rush University Medical Center Offers Mobile Stroke Treatment Unit
  The Rush University Medical Center stroke program is one of the few in the country to offer a mobile stroke treatment unit as a part of its emergency medical services. This year Rush will join Excellence Inc. at the International Stroke Conference 2017 where the RUSH mobile stroke treatment unit will make its debut. On display will be the unit’s state-of-the-art features, including the ability to diagnose patients for a stroke on-site with an onboard CT scanner. Rush University Medical Center’s stroke program was one of the first in Chicago to receive comprehensive certification from the J...
Source: JEMS Patient Care - February 10, 2017 Category: Emergency Medicine Authors: Excellence Tags: News Videos Ambulances & Vehicle Ops Patient Care Source Type: news

Dysfunction of Iron Metabolism and Iron-Regulatory Proteins in the Rat Hippocampus After Heat Stroke
Heat stroke, the most serious type of heat illness, refers to the presence of hyperthermia (core temperature>40°C), accompanied by central nervous system dysfunction. The hippocampus is a particularly vulnerable region in the early stage of heat stroke. Increasing evidence suggests that dysregulation of brain iron metabolism is involved in many neurodegenerative diseases. However, whether heat stroke causes dysfunction of iron metabolism, as well as iron-regulatory proteins, in the hippocampus remains unknown. The present study was conducted to explore the effects on spatial learning and memory, as well as iron content, f...
Source: Shock - May 15, 2019 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Pulsara and iSchemaView Unveil New RAPID Integration
Bozeman, Mont. & Menlo Park, Calif. — Pulsara has expanded its integration strategy by partnering with iSchemaView, the worldwide leader in advanced imaging for stroke. By leveraging Pulsara's open API infrastructure, iSchemaView now streamlines the sharing of its RAPID imaging platform for stroke care collaboration globally. Pulsara’s seamless integration with iSchemaView is a natural fit with Pulsara’s stroke module. “Integration is key. From the outset, we built our platform on an open API infrastructure,” said James Woodson, Pulsara founder and CEO. “By working with iSchemaView, we’re coordinating wit...
Source: JEMS Operations - February 4, 2019 Category: Emergency Medicine Authors: Pulsara (press release) Tags: Press Releases Operations Source Type: news

Isolated middle cerebral artery dissection: a systematic review
Abstract Acute stroke can be missed in the emergency department, particularly in younger patients and in those with more vague symptoms such as headache or dizziness. Cervicocephalic dissections are one group of etiologies for acute stroke in the young. While cervicocephalic dissections are not uncommon in clinical practice, isolated middle cerebral artery dissection (MCAD) has been rarely reported as a cause for stroke. We sought to review the clinical implications and pathophysiology of an isolated MCAD. We searched the medical literature for isolated MCAD in clinical stroke patients using MEDLINE, HighWire, an...
Source: International Journal of Emergency Medicine - December 17, 2014 Category: Emergency Medicine Source Type: research

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

Highlights from the literature
An egg a day is ok Sophia was pleased to learn from research published in the BMJ (2013;346:e8539) that consumption of up to one egg per day is not associated with an increased risk of stroke or coronary heart disease. This news follows the widely publicised counter-intuitive message from research which appeared in JAMA (2013;309:71–82) that ‘overweight people live longer’. Chest compression only CPR Arguments continue about whether compression only cardiopulmonary resuscitation (CPR) is better than conventional CPR for adult patients who suffer sudden unexpected out of hospital cardiac arrest. A nationwi...
Source: Emergency Medicine Journal - February 13, 2013 Category: Emergency Medicine Authors: Slabbert, J., Wyatt, J. Tags: Miscellaneous Source Type: research

Automated Outcome Classification of Computed Tomography Imaging Reports for Pediatric Traumatic Brain Injury
ConclusionsA hybrid NLP and machine learning automated classification system continues to show promise in coding free‐text electronic clinical data. For complex outcomes, it can reliably identify negative reports, but manual review of positive reports may be required. As such, it can still streamline data collection for clinical research and performance improvement.
Source: Academic Emergency Medicine - January 14, 2016 Category: Emergency Medicine Authors: Kabir Yadav, Efsun Sarioglu, Hyeong−Ah Choi, Walter B. Cartwright, Pamela S. Hinds, James M. Chamberlain Tags: Original Contribution Source Type: research

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