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Total 1761 results found since Jan 2013.

A Paradigm Shift in EMS Evaluation Of Stroke
Background Montgomery County Hospital District EMS (MCHD) is collaborating with the South East Texas Regional Advisory Committee (SETRAC) to validate their existing prehospital suspected neurological event guideline for stroke assessment and transport. MCHD is a non-fire based EMS service in Montgomery County, Texas. We respond to approximately 58,000 calls to service and identify stroke in more than 500 patients per year. Our EMS system covers an estimated 1,100-square-mile service area and has 190 medics, 900 EMTs and 15 first responder (FR) organizations. Acute ischemic stroke (AIS) is a debilitating and costly disease ...
Source: JEMS Patient Care - August 12, 2016 Category: Emergency Medicine Authors: Robert L. Dickson, MD, FAAEM, FACEP, FACEM Tags: Patient Care Source Type: news

Neurology Concepts: Young Women and Ischemic Stroke: Evaluation and Management in the Emergency Department
ConclusionUnique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 24, 2017 Category: Emergency Medicine Authors: Bernard P. Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E. Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen Tags: Original Contribution Source Type: research

Neurology Concepts: Young Women and Ischemic Stroke —Evaluation and Management in the Emergency Department
ConclusionUnique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment of this population.
Source: Academic Emergency Medicine - October 10, 2017 Category: Emergency Medicine Authors: Bernard P. Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E. Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen Tags: Original Contribution Source Type: research

The positive predictive value of an ambulance prealert for stroke and transient ischaemic attack
Conclusion The diagnosis of true-positive stroke can be difficult in the prehospital environment. Although prealert has been shown to improve the patient’s journey in terms of door-to-thrombolysis times, we have identified that the prealert has a significant false-positive rate that has important resource allocation and activation consequences. Further analysis of this may inform paramedic training and improve protocols for information handover.
Source: European Journal of Emergency Medicine - November 2, 2018 Category: Emergency Medicine Tags: ORIGINAL ARTICLES Source Type: research

Jefferson Health and Bensalem Rescue Squad Unveil Mobile Stroke Unit
BENSALEM, PA — On Thursday, May 16, the Vickie and Jack Farber Institute for Neuroscience at Jefferson and the Bensalem Rescue Squad introduced during a formal ribbon-cutting ceremony a new Mobile Stroke Unit (MSU) that will serve stroke patients in Bucks County. The event was hosted by leaders from Jefferson Health and Bensalem Township, who touted the unit’s unique capabilities to aid victims of stroke. The MSU will be based in Bucks County and is the region’s first university-based, high-tech Mobile Stroke Unit. It will work with emergency medical services, Jefferson Expert Telestroke (JET) physician team, and med...
Source: JEMS: Journal of Emergency Medical Services News - May 24, 2019 Category: Emergency Medicine Tags: Ambulances & Vehicle Ops News Press Releases Source Type: news

Long-Term Mortality Among ICU Patients With Stroke Compared With Other Critically Ill Patients
Conclusions: Stroke patients who need intensive care treatment have a high short-term mortality risk, but this alters favorably with increasing duration of survival time after ICU admission in patients with both ischemic stroke and intracerebral hemorrhage, especially compared with other populations of critically ill patients such as sepsis or severe community-acquired pneumonia patients.
Source: Critical Care Medicine - September 12, 2020 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Management of Acute Ischemic Stroke
Conclusions: Appropriate treatment of ischemic stroke is essential in the reduction of mortality and morbidity. Management of stroke involves a multidisciplinary approach that starts and extends beyond hospital admission.
Source: Critical Care Medicine - October 14, 2020 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Is the Early Diagnosis of Pediatric Stroke Possible in the Emergency Department?
Conclusions Childhood stroke is a neurological emergency that requires a multidisciplinary approach. Early stroke diagnosis is vital for treatment and prognosis. With respect to sudden neurological deficits, particularly dysarthria, altered consciousness, hemiplegia, and hemiparesis, should alert clinicians to stroke. In addition, interdepartmental cooperation is essential both in the rapid recognition of stroke and the treatment and follow-up processes.
Source: Pediatric Emergency Care - November 1, 2022 Category: Emergency Medicine Tags: Original Articles Source Type: research

Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke
AbstractTo investigate the association between the Emergency Medical Service dispatcher ’s initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017–2018) were in cluded if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1–76.0) co...
Source: Internal and Emergency Medicine - June 27, 2023 Category: Emergency Medicine Source Type: research

HINTS Outperforms ABCD2 to Screen for Stroke in Acute Continuous Vertigo and DizzinessEl HINTS Supera el ABCD2 en el Despistaje del Ictus en los Pacientes con Vértigo y Mareo Agudos Persistentes
ConclusionsHINTS substantially outperforms ABCD2 for stroke diagnosis in ED patients with AVS. It also outperforms MRI obtained within the first 2 days after symptom onset. While HINTS testing has traditionally been performed by specialists, methods for empowering emergency physicians (EPs) to leverage this approach for stroke screening in dizziness should be investigated. Resumen ObjetivosEl mareo y el vértigo contabilizan aproximadamente 4 millones de visitas anuales a los servicios de urgencias (SU) en Estados Unidos, y de 160.000 a 240.000 (4% al 6%) tienen un origen cerebrovascular. El diagnóstico de ictus en los ...
Source: Academic Emergency Medicine - October 15, 2013 Category: Emergency Medicine Authors: David E. Newman‐Toker, Kevin A. Kerber, Yu‐Hsiang Hsieh, John H. Pula, Rodney Omron, Ali S. Saber Tehrani, Georgios Mantokoudis, Daniel F. Hanley, David S. Zee, Jorge C. Kattah Tags: Original Research Contribution Source Type: research

Out-of-Hospital Stroke Screen Accuracy in a State With an Emergency Medical Services Protocol for Routing Patients to Acute Stroke Centers
Conclusion The CPSS and LAPSS had similar test characteristics, with each having only limited specificity. Development of stroke screening scales that optimize both sensitivity and specificity is required if these are to be used to determine transport diversion to acute stroke centers.
Source: Annals of Emergency Medicine - October 31, 2014 Category: Emergency Medicine Source Type: research

Prediction of Large Vessel Occlusions in Acute Stroke: National Institute of Health Stroke Scale Is Hard to Beat*
Objectives: Endovascular treatment for acute ischemic stroke with a large vessel occlusion was recently shown to be effective. We aimed to develop a score capable of predicting large vessel occlusion eligible for endovascular treatment in the early hospital management. Design: Retrospective, cohort study. Setting: Two tertiary, Swiss stroke centers. Patients: Consecutive acute ischemic stroke patients (1,645 patients; Acute STroke Registry and Analysis of Lausanne registry), who had CT angiography within 6 and 12 hours of symptom onset, were categorized according to the occlusion site. Demographic and clinical informati...
Source: Critical Care Medicine - May 17, 2016 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

A radiologist’s guide to the clinical scales used in the 2015 Endovascular Stroke Trials and the Revised American Heart Association/American Stroke Association Guidelines for Endovascular Stroke Treatment
Abstract In 2015, five trials demonstrated the efficacy of endovascular treatment for acute stroke, culminating in the revised American Heart Association/American Stroke Association (AHA/ASA) recommendations for stroke management. The different clinical scales used in these trials may be unfamiliar to emergency and on-call radiologists. The modified Rankin Scale was used to describe patient disability for prestroke assessment in three of the trials and for the 90-day follow up in all five trials. The Barthel index was used in one trial to score prestroke ability to perform activities of daily living. The NIH Strok...
Source: Emergency Radiology - July 6, 2016 Category: Emergency Medicine Source Type: research