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https://www.readbyqxmd.com/read/29217362/rethinking-prehospital-stroke-notification-assessing-utility-of-emergency-medical-services-impression-and-cincinnati-prehospital-stroke-scale
#1
Stephen W English, Alejandro A Rabinstein, Jay Mandrekar, James P Klaas
BACKGROUND AND PURPOSE: Although prehospital stroke notification has improved stroke treatment, incorporation of these systems into existing infrastructure has resulted in new challenges. The goal of our study was to design an effective prehospital notification system that allows for early and accurate identification of patients presenting with acute stroke. METHODS: We conducted a retrospective single-center cohort study of patients presenting with suspicion of acute stroke from 2014 to 2015...
December 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29158105/the-effect-and-associated-factors-of-dispatcher-recognition-of-stroke-a-retrospective-observational-study
#2
Ming-Ju Hsieh, Kuo-Liong Chien, Jen-Tang Sun, Sung-Chun Tang, Li-Kai Tsai, Wen-Chu Chiang, Yu-Chun Chien, Jiann-Shing Jeng, Matthew Huei-Ming Ma
BACKGROUND/PURPOSE: Details of the communication between the caller and dispatcher have not been reported previously in Taiwan. This study aimed to: (1) understand the details of the communication between the caller and dispatcher among the calls for stroke patients, (2) identify factors associated with stroke recognition by dispatchers, and (3) evaluate the association between stroke recognition by dispatchers and stroke management. METHODS: We conducted a retrospective observational study involving patients with stroke or transient ischemic stroke transported by the emergency medical service, and arriving at 9 hospitals in Taipei within 3 h of symptom onset from January 1, 2013 to February 28, 2014...
November 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29147858/community-interventions-to-increase-stroke-preparedness-and-acute-stroke-treatment-rates
#3
REVIEW
Kathleen M Kelly, Kathryn T Holt, Gina M Neshewat, Lesli E Skolarus
PURPOSE OF REVIEW: Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness...
November 16, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29140185/thrombolysis-improving-door-to-needle-times-for-ischemic-stroke-treatment-a-narrative-review
#4
Noreen Kamal, Eric E Smith, Thomas Jeerakathil, Michael D Hill
Background The effectiveness of thrombolysis is highly time dependent. For this reason, short target times have been set to reduce time to treatment from hospital arrival, which is called door-to-needle time. Summary of review There has been considerable work done at single centers and across multiple hospitals to improve door-to-needle time. There have been reductions of 8 to 47 min when applying one or more improvement strategies at single centers, and there have been many multi-hospital initiatives. The delays to treatment have been attributed to both patient and hospital factors, and strategies to address these delays have been proven to reduce door-to-needle time...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29132482/effectiveness-of-functional-electrical-stimulation-fes-versus-conventional-electrical-stimulation-in-gait-rehabilitation-of-patients-with-stroke
#5
Freeha Sharif, Samina Ghulam, Arshad Nawaz Malik, Quratulain Saeed
OBJECTIVE: To compare the effectiveness of functional electrical stimulation (FES) versus conventional electrical stimulation in gait rehabilitation of patients with stroke for finding the most appropriate problem-oriented treatment for foot drop patients in a shorter time period. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, from July to December 2016...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29070716/plumber-study-prevalence-of-large-vessel-occlusion-strokes-in-mecklenburg-county-emergency-response
#6
Adeline Dozois, Lorrie Hampton, Carlene W Kingston, Gwen Lambert, Thomas J Porcelli, Denise Sorenson, Megan Templin, Shellie VonCannon, Andrew W Asimos
BACKGROUND AND PURPOSE: The recently proposed American Heart Association/American Stroke Association EMS triage algorithm endorses routing patients with suspected large vessel occlusion (LVO) acute ischemic strokes directly to endovascular centers based on a stroke severity score. The predictive value of this algorithm for identifying LVO is dependent on the overall prevalence of LVO acute ischemic stroke in the EMS population screened for stroke, which has not been reported. METHODS: We performed a cross-sectional study of patients transported by our county's EMS agency who were dispatched as a possible stroke or had a primary impression of stroke by paramedics...
October 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29046934/-knowledge-of-the-population-about-leading-symptoms-of-cardiovascular-emergencies-and-the-responsibility-and-accessibility-of-medical-facilities-in-emergencies-results-of-the-kzen-study-in-western-palatinate
#7
T Luiz, S Dittrich, G Pollach, C Madler
BACKGROUND: The Westpfalz is a mainly rural region in the southwestern part of the German state of Rhineland-Palatinate with 527,000 inhabitants and demonstrates a higher than average cardiovascular mortality compared to the rest of Germany. The reasons are not known. Our study attempted to investigate whether significant deficits in knowledge of the population on cardiovascular emergencies, the accessibility of emergency medical services (EMS) or the different responsibilities and abilities of the medical facilities could be held responsible for this...
November 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29023166/prehospital-stroke-assessment-for-large-vessel-occlusions-a-systematic-review
#8
William Krebs, Travis P Sharkey-Toppen, Fern Cheek, Eric Cortez, Ashley Larrimore, David Keseg, Ashish R Panchal
BACKGROUND AND OBJECTIVE: Stroke is the leading cause of disability in the United States and new evidence shows interventional procedures provide better outcomes for large vessel occlusions (LVO). We performed a systematic review of the literature on prehospital stroke scales used to identify LVOs comparing the scales with analysis of the sensitivity, specificity, and predictive values. The goal was to determine if emergency medical services (EMS) are able to accurately identify LVO in the field...
October 12, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28975971/the-relationship-between-serum-cxcl16-level-and-carotid-vulnerable-plaque-in-patients-with-ischemic-stroke
#9
G Jin
OBJECTIVE: We investigated the relationship between the serum macrophage chemokine ligand 16 (CXCL16) levels and the vulnerable carotid plaque in patients with ischemic stroke. PATIENTS AND METHODS: We successively selected 118 cases of patients with an initial diagnosis of acute ischemic stroke (time of onset < 72 h), recorded risk factors, including gender, age, family history, smoking, body mass index, blood glucose levels, blood lipid levels, average systolic pressure and diastolic blood pressure (DBP) and homocysteine levels...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28959230/accuracy-of-emergency-medical-services-dispatcher-and-crew-diagnosis-of-stroke-in-clinical-practice
#10
Judy Jia, Roger Band, Michael E Abboud, William Pajerowski, Michelle Guo, Guy David, C Crawford Mechem, Steven R Messé, Brendan G Carr, Michael T Mullen
BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city. METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28936069/prehospital-management-of-acute-stroke-in-rural-versus-urban-responders
#11
Gregory Hansen, Simerpreet Bal, Kerri Lynn Schellenberg, Susan Alcock, Esseddeeg Ghrooda
OBJECTIVE: Stroke guideline compliance of rural Canadian prehospital emergency medical services (EMS) care in acute stroke is unknown. In this quality assurance study, we sought to compare rural and urban care by prehospital EMS evaluation/management indicators from patients assessed at an urban Canadian stroke center. MATERIALS AND METHODS: One hundred adult patients were randomly selected from the stroke registry. Patients were transported through Rural EMS bypass protocols or urban EMS protocols (both bypass and direct) to our stroke center between January and December 2013...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#12
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
November 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28864702/design-and-validation-of-a-clinical-scale-for-prehospital-stroke-recognition-severity-grading-and-prediction-of-large-vessel-occlusion-the-shortened-nih-stroke-scale-for-emergency-medical-services
#13
Jan Christoph Purrucker, Florian Härtig, Hardy Richter, Andreas Engelbrecht, Johannes Hartmann, Jonas Auer, Christian Hametner, Erik Popp, Peter Arthur Ringleb, Simon Nagel, Sven Poli
OBJECTIVE: To develop an NIH Stroke Scale (NIHSS)-compatible, all-in-one scale for rapid and comprehensive prehospital stroke assessment including stroke recognition, severity grading and progression monitoring as well as prediction of large vessel occlusion (LVO). METHODS: Emergency medical services (EMS) personnel and stroke physicians (n=326) rated each item of the NIHSS regarding suitability for prehospital use; best rated items were included. Stroke recognition was evaluated retrospectively in 689 consecutive patients with acute stroke or stroke mimics, prediction of LVO in 741 consecutive patients with ischaemic stroke with acute vessel imaging independent of admission NIHSS score...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862480/national-characteristics-of-emergency-medical-services-responses-for-older-adults-in-the-united-states
#14
Hieu V Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E Jacobson, Jestin N Carlson, N Clay Mann, Henry E Wang
OBJECTIVE: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. METHODS: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses...
September 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28841085/observational-multicenter-study-of-a-direct-to-ct-protocol-for-ems-transported-patients-with-suspected-stroke
#15
David C Cone, Craig Cooley, Jeffrey Ferguson, Andrew J Harrell, Jeffrey H Luk, Christian Martin-Gill, Sean W Marquis, Scott Pasichow
OBJECTIVE: In an effort to decrease door-to-needle times for patients with acute ischemic stroke, some hospitals have begun taking stable EMS patients with suspected stroke directly from the ambulance to the CT scanner, then to an emergency department (ED) bed for evaluation. Minimal data exist regarding the potential for time savings with such a protocol. The study hypothesis was that a direct-to-CT protocol would be associated with decreases in both door-to-CT-ordered and door-to-needle times...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28813914/data-sample-size-needed-for-analysis-of-kinematic-and-muscle-synergies-in-healthy-and-stroke-populations
#16
Navid Lambert-Shirzad, H F Machiel Van der Loos
Multiple studies have suggested the central nervous system (CNS) generates motions by using modular control of muscles and joints (synergies). However, the synergies reported by these studies are task dependent and might not reflect the true control strategies adopted by the CNS. Studying exploratory motions (EMs) can reveal biomechanical constraints and motor control strategies in healthy and clinical populations. The first logical step to consider EMs in study of motor synergies is to determine how much data is required to reliably and fully profile the motion patterns of an individual...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28804875/prehospital-pathways-of-occipital-stroke-patients-with-mainly-visual-symptoms
#17
S Räty, K Silvennoinen, T Tatlisumak
OBJECTIVES: Occipital ischemic strokes typically cause homonymous visual field defects, for which means of rehabilitation are limited. Intravenous thrombolysis is increasingly and successfully used for their acute treatment. However, recognition of strokes presenting with mainly visual field defects is challenging for both patients and healthcare professionals. We studied prehospital pathways of occipital stroke patients with mainly visual symptoms to define obstacles in their early recognition...
August 13, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28683821/stroke-awareness-among-dubai-emergency-medical-service-staff-and-impact-of-an-educational-intervention
#18
Fatima Shire, Zahra Kasim, Suhail Alrukn, Maria Khan
BACKGROUND: Emergency medical services (EMS) play a vital role in expediting hospital arrival in stroke patients. The objective of our study was to assess the level of awareness regarding pre-hospital identification and management of acute stroke among EMS Staff in Dubai and to evaluate the impact of an educational lecture on their knowledge. METHODS: Ours was a cross-sectional study with a pre-test and post-test design. The intervention was an educational lecture, based on the updated guidelines in pre-hospital care of acute stroke...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28646851/development-of-an-education-campaign-to-reduce-delays-in-pre-hospital-response-to-stroke
#19
Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti, Licia Denti
BACKGROUND: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness. METHODS: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28641984/bi-objective-approach-for-placing-ground-and-air-ambulance-base-and-helipad-locations-in-order-to-optimize-ems-response
#20
Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster...
June 15, 2017: American Journal of Emergency Medicine
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