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Specialty: Emergency Medicine
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Total 683 results found since Jan 2013.

Patient behaviour at the time of stroke onset: a cross-sectional survey of patient response to stroke symptoms
Conclusions This study provides insights into patient response when a stroke occurs, with the presence and action of others highlighted as critical in fast response to stroke symptoms. Knowledge of stroke warning signs and risk factors was low among stroke survivors. Findings highlight the complexity of changing help-seeking behaviour during stroke onset, and provide directions for public education efforts to reduce prehospital delay.
Source: Emergency Medicine Journal - May 18, 2016 Category: Emergency Medicine Authors: Mellon, L., Doyle, F., Williams, D., Brewer, L., Hall, P., Hickey, A. Tags: Stroke, Radiology, Clinical diagnostic tests Original article Source Type: research

Patients' and carers' experiences of gaining access to acute stroke care: a qualitative study
Conclusions The stroke awareness social marketing campaign has contributed to public knowledge and was perceived to assist in reducing prehospital delay. It has also resulted in an enhanced knowledge of the significance of rapid treatment on admission to hospital and raised public expectation of EMS and stroke services to act fast. More research is required to assist organisational change to reduce in-hospital delay.
Source: Emergency Medicine Journal - November 14, 2013 Category: Emergency Medicine Authors: Harrison, M., Ryan, T., Gardiner, C., Jones, A. Tags: Stroke Original article Source Type: research

Vomiting should be a prompt predictor of stroke outcome
Conclusions Compared with patients without vomiting, the risk of death was significantly higher in patients with vomiting at the onset of stroke. Vomiting should be an early predictor of the outcome.
Source: Emergency Medicine Journal - August 13, 2013 Category: Emergency Medicine Authors: Shigematsu, K., Shimamura, O., Nakano, H., Watanabe, Y., Sekimoto, T., Shimizu, K., Nishizawa, A., Makino, M. Tags: Drugs: cardiovascular system, Stroke, Hypertension Original article Source Type: research

Is air transport of stroke patients faster than ground transport? A prospective controlled observational study
Conclusions We found significantly shorter time from contact to triaging neurologist to arrival in the regional stroke centre if stroke patients were transported by primarily dispatched ground ambulance compared with a secondarily dispatched helicopter.
Source: Emergency Medicine Journal - March 12, 2014 Category: Emergency Medicine Authors: Hesselfeldt, R., Gyllenborg, J., Steinmetz, J., Do, H. Q., Hejselbaek, J., Rasmussen, L. S. Tags: Stroke, Radiology, Clinical diagnostic tests Original article Source Type: research

Paramedic Initiated Lisinopril For Acute Stroke Treatment (PIL-FAST): results from the pilot randomised controlled trial
Conclusions It is possible to conduct a paramedic initiated double-blind RCT of a treatment for acute stroke. However, to perform a definitive RCT in a reasonable timescale, a large number of trained paramedics across several ambulance services would be needed to recruit the number of patients likely to be required. Clinical trial registration http://www.clinicaltrials.gov. Unique identifier: NCT01066572.
Source: Emergency Medicine Journal - November 19, 2014 Category: Emergency Medicine Authors: Shaw, L., Price, C., McLure, S., Howel, D., McColl, E., Younger, P., Ford, G. A. Tags: Open access, Stroke, Hypertension, Resuscitation Original article Source Type: research

Reasons and evolution of non-thrombolysis in acute ischaemic stroke
Conclusion Onset-to-admission delays remain the main exclusion criterion for thrombolysis. Among early arrivals, relative contraindications such as minor stroke severity and advanced age were frequent. Thrombolysis rate increased with the reduction of thrombolysis restrictions (eg, age and stroke severity).
Source: Emergency Medicine Journal - March 23, 2017 Category: Emergency Medicine Authors: Reiff, T., Michel, P. Tags: Open access, Stroke, Radiology, Clinical diagnostic tests Original article Source Type: research

The association between prehospital care and in-hospital treatment decisions in acute stroke: a cohort study
Conclusions This study highlights the importance of hospital prealerting, accurate stroke recognition, and recording of onset time. Those not recognised with stroke in a prehospital setting appear to be excluded from the possibility of rapid treatment in hospital, even before they have been seen by a specialist.
Source: Emergency Medicine Journal - January 20, 2015 Category: Emergency Medicine Authors: Sheppard, J. P., Mellor, R. M., Greenfield, S., Mant, J., Quinn, T., Sandler, D., Sims, D., Singh, S., Ward, M., McManus, R. J., Carr, Helliwell, Nand, Phillips, Scott, on behalf of the CLAHRC BBC investigators Tags: Open access, Stroke Original article Source Type: research

'Is he awake?': dialogues between callers and call handlers about consciousness during emergency calls for suspected acute stroke
Conclusion Ambiguities and contradictions in dialogue about conscious level arise during ambulance calls for suspected and confirmed stroke. Further study is needed to identify whether these issues also arise in non-stroke calls, and which terms are best understood by the public in describing conscious level.
Source: Emergency Medicine Journal - April 12, 2013 Category: Emergency Medicine Authors: Gibson, J. M. E., Bullock, M., Ford, G. A., Jones, S. P., Leathley, M. J., McAdam, J. J., Quinn, T., Watkins, C. L., on behalf of the ESCORTT group Tags: Stroke Prehospital care Source Type: research

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

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