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Total 1761 results found since Jan 2013.

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

The Changes in Pulse Pressure Variation or Stroke Volume Variation After a “Tidal Volume Challenge” Reliably Predict Fluid Responsiveness During Low Tidal Volume Ventilation*
Conclusions: The changes in pulse pressure variation or stroke volume variation obtained by transiently increasing tidal volume (tidal volume challenge) are superior to pulse pressure variation and stroke volume variation in predicting fluid responsiveness during low tidal volume ventilation.
Source: Critical Care Medicine - February 18, 2017 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Mobile Stroke Units —the Changing Face of Emergency Medicine Stroke Management
AbstractPurpose of ReviewTo provide a summary of mobile stroke unit (MSU) utilization within Emergency Medicine stroke systems.Recent FindingsMSUs have been deployed around the world into prehospital stroke systems demonstrating the ability to differentiate stroke subtypes and to initiate thrombolysis in eligible patients with shorter symptom onset to treatment times than conventional systems. MSU technology may enable the administration of other standard interventions or future experimental agents in the hyperacute time window. It is conceivable that MSU technology may be extended to other disease states in resource-limit...
Source: Current Emergency and Hospital Medicine Reports - January 12, 2020 Category: Emergency Medicine Source Type: research

Large Vessel Occlusion Stroke Detection in the Prehospital Environment
AbstractPurpose of ReviewEndovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.Recent FindingsClinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospi...
Source: Current Emergency and Hospital Medicine Reports - June 28, 2021 Category: Emergency Medicine Source Type: research

ABCD2, ABCD2-I, and OTTAWA scores for stroke risk assessment: a direct retrospective comparison
The objective is to compare the accuracy of ABCD2, ABCD2-I, and OTTAWA scores in the prediction of a stroke at 7, 90  days, and 1 year in patients presenting with TIA. Single-centre, retrospective study including patients with TIA admitted to the Emergency Department of our third-level, University Hospital, between 2018 and 2019. Five hundred three patients were included. Thirty-nine (7.7%) had a stroke within 1  year from the TIA: 9 (1.7%) and 24 (4.7%) within 7 and 90 days, respectively. ABCD2, ABCD2-I, and OTTAWA scores were significantly higher in patients who developed a stroke. AUROCs ranged from 0.66 to 0.75, wi...
Source: Internal and Emergency Medicine - August 20, 2022 Category: Emergency Medicine Source Type: research

Impact of Emergency Medical Services Stroke Routing Protocols on Primary Stroke Center Certification in California: Schuberg S, Song S, Saver JL, Mack WJ, Cen SY, Sanossian N. Stroke 2013;44:3584–6.
This study sought to examine the correlation between the adoption of emergency medical services (EMS) routing protocols and the conversion of receiving centers to designated primary stroke centers (PSCs) in the state of California between 2003 and 2012. The hypothesis is that continued access to patients is the key driver in motivating hospitals to seek PSC certification. The authors obtained dates of implementation for EMS routing protocols from local EMS agencies and compared them with the date in which local PSCs attained their designation as stroke centers from the Joint Commission. They then examined the rate of conve...
Source: The Journal of Emergency Medicine - February 27, 2014 Category: Emergency Medicine Authors: Ben Murphy Tags: Abstracts Source Type: research

Decisions and Delays Within Stroke Patients’ Route to the Hospital: A Qualitative Study
Conclusion Despite campaigns to increase public awareness of stroke symptoms, the behavior of both patients and health service providers apparently led to delays in the recognition of and response to stroke symptoms, potentially reducing access to optimum and timely acute specialist assessment and treatment for acute stroke.
Source: Annals of Emergency Medicine - November 16, 2014 Category: Emergency Medicine Source Type: research

Increased risk of ischemic stroke in patients with mild traumatic brain injury: a nationwide cohort study
Conclusion: Mild traumatic brain injury is an independent significant risk factor for ischemic stroke.
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - November 19, 2014 Category: Emergency Medicine Authors: Yi-Kung LeeChen-Wen LeeMing-Yuan HuangChen-Yang HsuYung-Cheng Su Source Type: research

Stroke Prophylaxis in Atrial Fibrillation: Searching for Management Improvement Opportunities in the Emergency Department: The HERMES-AF Study
Conclusion In Spain, most patients with atrial fibrillation treated in EDs who do not receive anticoagulation are at high risk of stroke, with relevant differences with regard to the risk stratification scheme used. Anticoagulation is underused, mainly because the risk of stroke is underestimated by the treating physicians and the benefits of antiplatelets are overrated, principally in female patients and the elderly. Efforts to increase the prescription of anticoagulation in these patients appear warranted.
Source: Annals of Emergency Medicine - December 22, 2014 Category: Emergency Medicine Source Type: research

Thrombolysis and Clinical Outcome in Patients with Stroke After Implementation of the Tyrol Stroke Pathway: A Retrospective Observational Study
This is a retrospective observational study that investigated the impact of implementing a stroke treatment pathway, Tyrol Stroke Pathway, throughout a mountain state in Austria. The main outcomes of the study were the rate of thrombolysis administration, mortality, and other patient-centered clinical outcomes. The Tyrol Stroke Pathway was comprehensive and included stroke awareness campaigns, standardization of stroke care, educational opportunities for health care professionals, standardized documentation tools, targeted interventions to improve the care of stroke patients, standardization of diagnosis and therapeutics, ...
Source: The Journal of Emergency Medicine - May 1, 2015 Category: Emergency Medicine Authors: Spencer Tomberg Tags: Abstract Source Type: research

The Association Between Emergency Department Crowding and the Disposition of Patients With Transient Ischemic Attack or Minor Stroke.
CONCLUSIONS: These results suggest that crowding may influence clinical decision-making in the disposition of patients with TIA or minor stroke and that, as crowding worsens, the likelihood of hospitalization increases. PMID: 26398233 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - September 23, 2015 Category: Emergency Medicine Authors: Ben-Yakov M, Kapral MK, Fang J, Li S, Vermeulen MJ, Schull MJ Tags: Acad Emerg Med Source Type: research

Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine.
CONCLUSIONS: Given the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund the up-front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care. PMID: 26720746 [PubMed - in process]
Source: Accident and Emergency Nursing - January 1, 2016 Category: Emergency Medicine Authors: Torabi E, Froehle CM, Lindsell CJ, Moomaw CJ, Kanter D, Kleindorfer D, Adeoye O Tags: Acad Emerg Med Source Type: research

Predictors of hospital readmission 1  year after ischemic stroke
AbstractPredictors of short-term readmission after ischemic stroke have been previously identified, but few studies analyzed predictors of long-term readmission, namely early imaging findings and treatment with intravenous thrombolysis (IVT). To characterize predictors of hospital readmission during the first year after hospitalization for ischemic stroke. The study consists of a retrospective cohort of consecutive ischemic stroke patients admitted in a Portuguese university hospital during 2013, who survived index hospitalization. We collected clinical and imaging information using the electronical clinical record. Inform...
Source: Internal and Emergency Medicine - August 5, 2016 Category: Emergency Medicine Source Type: research

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