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Language preference does not influence stroke patients' symptom recognition or emergency care time metrics
Our objective was to determine whether acute ischemic stroke (AIS) patients' language preference is associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time.
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Kori S. Zachrison, Shaw Natsui, Betty M. Luan Erfe, Nicte I. Mejia, Lee H. Schwamm 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

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

The use of an emergency department dysphagia screen is associated with decreased pneumonia in acute strokes
Dysphagia is a common problem for patients after an acute stroke which can lead to hospital acquired pneumonia (HAP) increasing morbidity and mortality. The Joint Commission has directed that stroke certified hospitals perform a dysphagia screen at the time of initial presentation. We sought to evaluate if our ED dysphagia screen was correlated with lower rates of pneumonia in acute stroke patients.
Source: The American Journal of Emergency Medicine - March 22, 2018 Category: Emergency Medicine Authors: Jon W. Schrock, Linda Lou, Benjamin A.W. Ball, J. Van Etten 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

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

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

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

Achieving regionalization through rural interhospital transfer
Regionalization of emergency medical care aims to provide consistent and efficient high-quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires interhospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital; capacity at the receiving hospital; and financial, geographic, and patien...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research

Achieving Regionalization through Rural Inter-hospital Transfer
Regionalization of emergency medical care aims to provide consistent and efficient high quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires inter-hospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital, capacity at the receiving hospital, financial, geographic, and patient-p...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review 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

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