Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Nov 2014
Multicenter Study Observational StudyThe quality of prehospital ischemic stroke care: compliance with guidelines and impact on in-hospital stroke response.
A number of emergency medical services (EMSs) performance measures for stroke have been proposed to promote early stroke recognition and rapid transportation to definitive care. This study examined performance measure compliance among EMS-transported stroke patients and the relationship between compliance and in-hospital stroke response. ⋯ EMS transportation at highest priority and hospital prenotification were associated with faster in-hospital stroke response and represent logical targets for EMS quality improvement efforts.
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J Stroke Cerebrovasc Dis · Nov 2014
Meta AnalysisTherapeutic hypothermia (different depths, durations, and rewarming speeds) for acute ischemic stroke: a meta-analysis.
Whether therapeutic hypothermia benefits patients with acute ischemic stroke (AIS) remains controversial. The aim of this study was to evaluate the efficacy and safety of the different depths, durations, and rewarming speeds of therapeutic hypothermia for AIS. ⋯ These limited data suggest that therapeutic hypothermia does not significantly improve stroke outcomes and may lead to higher rates of pneumonia. Multicenter RCTs with larger samples are needed to confirm the current findings.
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J Stroke Cerebrovasc Dis · Nov 2014
A geographic information system analysis of the impact of a statewide acute stroke emergency medical services routing protocol on community hospital bypass.
Our goal was to determine if a statewide Emergency Medical Services (EMSs) Stroke Triage and Destination Plan (STDP), specifying bypass of hospitals unable to routinely treat stroke patients with thrombolytics (community hospitals), changed bypass frequency of those hospitals. ⋯ Missing symptom duration time and data records in our state's EMS data system, along with conflicting hospital classifications between EMS agencies limit the ability to study statewide stroke routing protocols. Bypass policies may apply to a minority of patients because a community hospital is not the closest hospital to most stroke events. Given these limitations, we found no difference in community hospital bypass rates after implementation of the STDP.