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Source: The American Journal of Emergency Medicine
Management: Hospitals
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Total 25 results found since Jan 2013.
Emergency Transport of Stroke Suspects in a Rural State: Opportunities for Improvement
Time delay is the key obstacle for receiving successful stroke treatment. Alteplase therapy must start within 4.5 hours from stroke occurrence. Rapid transport to a Primary Stroke Center (PSC) or Acute Stroke Ready Hospital (ASRH) by the emergency medical system (EMS) paramedics is vital. We determined transport time and destination data for EMS identified and delivered stroke suspects in Arkansas during 2013. Our objective was to analyze transport time and the hospital qualification for stroke care across the state.
Source: The American Journal of Emergency Medicine - June 12, 2016 Category: Emergency Medicine Authors: Aliza T. Brown, Feifei Wei, William C. Culp, Greg Brown, Ryan Tyler, Appathurai Balamurugan, Nicolas Bianchi Tags: Brief Report Source Type: research
Emergency transport of stroke suspects in a rural state: opportunities for improvement
Time delay is the key obstacle for receiving successful stroke treatment. Alteplase therapy must start within 4.5 hours from stroke occurrence. Rapid transport to a primary stroke center (PSC) or acute stroke –ready hospital (ASRH) by the emergency medical system (EMS) paramedics is vital. We determined transport time and destination data for EMS-identified and -delivered stroke suspects in Arkansas during 2013. Our objective was to analyze transport time and the hospital qualification for stroke care across the state.
Source: The American Journal of Emergency Medicine - June 12, 2016 Category: Emergency Medicine Authors: Aliza T. Brown, Feifei Wei, William C. Culp, Greg Brown, Ryan Tyler, Appathurai Balamurugan, Nicolas Bianchi Tags: Brief Report Source Type: research
Factors associated with use of emergency medical services in patients with acute stroke
Abstract: Purposes: The aim of this study was to investigate the factors associated with use of emergency medical services (EMS) in patients with acute stroke.Methods: Prospective data on consecutive patients with acute stroke who presented to the emergency department of a university medical center from January 1, 2010, to July 31, 2011, were analyzed. Patients were excluded if they had an unknown residence, had onset of stroke at a nursing home or hospital, or were transferred from another hospital. Variables for all patients with stroke and ischemic stroke who did and did not use EMS were compared.Results: In total, 1344...
Source: The American Journal of Emergency Medicine - March 4, 2013 Category: Emergency Medicine Authors: Nai-Chuan Chen, Ming-Ju Hsieh, Sung-Chun Tang, Wen-Chu Chiang, Kuang-Yu Huang, Li-Kai Tsai, Patrick Chow-In Ko, Matthew Huei-Ming Ma, Jiann-Shing Jeng Tags: Original Contributions Source Type: research
Impact of an emergency medicine pharmacist on time to thrombolysis in acute ischemic stroke
The time to thrombolysis, commonly termed “door-to-needle” (DTN) is a measure of stroke center quality and effective patient care. The 2013 American Heart Association/American Stroke Association (AHA/ASA) Guidelines for the Early Management of Patients with Acute Ischemic Stroke recommend that hospitals administer thrombolytics to all eligible ischemic stroke patients in less than 60 minutes from arrival [1]. Time to initiation of thrombolytics in ischemic stroke patients has been associated with improved neurological outcomes, decreased adverse effects, and reduced mortality with early thrombolysis associated with the...
Source: The American Journal of Emergency Medicine - July 5, 2016 Category: Emergency Medicine Authors: Kayla Montgomery, A. Brad Hall, Georgia Keriazes Source Type: research
Systemic thrombolysis for stroke in pregnancy
Pregnancy is an exclusion criterion for all clinical trials that validate alteplase in acute stroke, so our knowledge about its use in this condition is relative only to case reports and case series. Herein, we report the successful use of intravenous recombinant tissue-type plasminogen activator (rt-PA) in pregnant women with acute stroke. The patient was a 28-year-old who was 16 weeks pregnant. She presented to our hospital 1 hour after a sudden onset of mothor aphasia, hemiparesis, and hypoesthesia on the right side due to incipient ischemia in the left cerebral hemisphere resulting from ipsilateral middle cerebral arte...
Source: The American Journal of Emergency Medicine - August 6, 2012 Category: Emergency Medicine Authors: Rossana Tassi, Maurizio Acampa, Giovanna Marotta, Samuele Cioni, Francesca Guideri, Simone Rossi, Alfonso Cerase, Giuseppe Martini Tags: Case Reports Source Type: research
Isolated basilar artery dissection—a rare cause of stroke in young adult
Syncope accounts for approximately 1% to 2% of emergency department visits each year and up to 6% of hospital admissions . The causes of syncope are numerous, from common benign disorders to life-threatening processes including transient ischemic attack and even stroke. Although cervicocerebral artery dissection is an uncommon etiology in ischemic stroke, it is the second leading cause in patients younger than 45 years, and most of them predominantly involved the extracranial artery . Dissections of intracranial arteries are increasingly being recognized with advanced imaging study; however, isolated basilar artery dissect...
Source: The American Journal of Emergency Medicine - June 17, 2013 Category: Emergency Medicine Authors: Yu-Wei Tsao, Jiann-Hwa Chen, Pai-Hao Huang, Wei-Lung Chen Tags: Case Reports Source Type: research
An educational intervention allows for greater prehospital recognition of acute stroke
We performed a study to determine whether a brief educational intervention directed at pre-hospital providers would increase the identification of stroke victims in the pre-hospital setting. The purpose of this IRB approved, before-and-after research project was to determine whether the implementation of Advanced Stroke Life Support Class (ASLS) [1] training for pre-hospital providers would lead to improved field identification of stroke.
Source: The American Journal of Emergency Medicine - May 23, 2017 Category: Emergency Medicine Authors: Tara K. Henry-Morrow, Bryan D. Nelson, Erin Conahan, Claranne Mathiesen, Bernadette Glenn-Porter, Matthew T. Niehaus, Lauren M. Porter, Mitchell R. Gesell, Gregory T. Monaghan, Jeanne L. Jacoby Tags: Correspondence Source Type: research
Can non-contrast head CT and stroke severity be used for stroke triage? A population-based study
Acute ischemic stroke (AIS) patients may benefit from endovascular thrombectomy (EVT) up to 24 h since last known normal (LKN). Advanced imaging is required for patient selection. Small or rural hospitals may not have sufficient CT technician and radiology support to rapidly acquire and interpret images. We estimated transfer rates using non-contrast head CT and stroke severity to select p atients to be transferred to larger centers for evaluation.
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Charles Kircher, Amanda Humphries, Dawn Kleindorfer, Kathleen Alwell, Heidi Sucharew, Charles J. Moomaw, Jason Mackey, Felipe De Los Rios La Rosa, Brett Kissela, Opeolu Adeoye Source Type: research
Ischemic Stroke Differential Diagnose: Spontaneous Spinal Epidural Hematoma can be fatal
Spontaneous Spinal Epidural Hematoma (SSEH) is rarely seen, it is the important reason for the spinal cord compression. Patients generally visit the doctor due to the acute pain in the neck and interscapular area. The male patient 58years old was admitted to the emergency service of our hospital with the sudden onset neck pain and followed by rapidly right hemiparesis He arrived at our hospital 120minutes after the onset of her symptoms with suspected acute stroke. We assessed for acute stroke performed clinical examinations necessary for intravenous thrombolytic treatment with alteplase, No abnormality was observed in his...
Source: The American Journal of Emergency Medicine - January 21, 2015 Category: Emergency Medicine Authors: Huseyin Buyukgol, M. Kemal Ilik, Faik Ilik Source Type: research
Prevention of emergency physician migratory contamination in a cluster randomized trial to increase tissue plasminogen activator use in stroke (the INSTINCT trial)
Cluster randomized trials (CRTs) are increasingly used to evaluate quality improvement interventions aimed at health care providers. In trials testing emergency department (ED) interventions, migration of emergency physicians (EPs) between hospitals is an important concern, as contamination may affect both internal and external validity. We hypothesized that geographically isolating EDs would prevent migratory contamination in a CRT designed to increase ED delivery of tissue plasminogen activator (tPA) in stroke (the INSTINCT trial).
Source: The American Journal of Emergency Medicine - September 6, 2014 Category: Emergency Medicine Authors: Victoria C. Weston, William J. Meurer, Shirley M. Frederiksen, Allison K. Fox, Phillip A. Scott Tags: Research Seminar Source Type: research
ED volume and functional status after acute ischemic stroke
Acute ischemic stroke (AIS) is a time-sensitive disease where rapid identification and treatment are critical [1-6]. Increased emergency department (ED) volume has been implicated in poor patient outcomes in other time-sensitive diagnoses [7-11]. Given that most of AIS care is provided at nontertiary care centers, it is important to understand the impact of ED process metrics in the community setting [12]. We sought to evaluate the impact of daily ED volumes on outcomes of patients with AIS in a community hospital.
Source: The American Journal of Emergency Medicine - August 22, 2014 Category: Emergency Medicine Authors: Stephanie Larson, Ken Uchino, Nicole Joseph, Jestin N. Carlson Tags: Correspondence Source Type: research
Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke
The objective of the current study was to assess whether HbA1c-based adjusted glycemic variables were associated with unfavorable outcomes among patients admitted to the hospital for AIS.
Source: The American Journal of Emergency Medicine - March 21, 2017 Category: Emergency Medicine Authors: Chih-Jen Yang, Wen-I Liao, Jen-Chun Wang, Chia-Lin Tsai, Jiunn-Tay Lee, Giia-Sheun Peng, Chien-Hsing Lee, Chin-Wang Hsu, Shih-Hung Tsai Source Type: research
National trends in stroke and TIA care in U.S. emergency departments and inpatient hospitalizations (2006 –2014)
We examine recent trends in U.S. emergency department (ED) and hospital care for stroke and transient ischemic attack (TIA).
Source: The American Journal of Emergency Medicine - August 8, 2018 Category: Emergency Medicine Authors: Islam I. Bedaiwi, Sukayna Z. Alfaraj, Jesse M. Pines Source Type: research
