Development of an acute ischemic stroke management course for hospital physicians in emergency departments and intensive care units

Abstract

The objective of this study was to evaluate a training course on acute ischemic stroke (AIS) for hospital physicians, part of a regional strategy on AIS patient care. The course comprised an initial self-study (e-Learning) stage and 1-day theoretical-practical course on initial AIS management for Critical Care and Emergency physicians in the Andalusian Health Service (Spain). Data were collected on regional implementation of the stroke code and intravenous thrombolysis treatment. Between 2006 and 2009, 12 courses were attended by 356 physicians from emergency (n=148) and critical care (n=208) departments in the Andalusian health system. The initial stage was failed by 46.4% of trainees; the 1-day AIS course was successfully completed by all trainees, who reported a high satisfaction level. By the end of 2009, all hospitals had adopted the stroke code and approximately 5-6% of patients with AIS received intravenous thrombolysis. This type of healthcare strategy proved effective to improve AIS care in our setting.

Stroke Knowledge in Spanish-Speaking Populations

“…However indirect findings suggest that misdiagnosis may interfere with initial stroke workup and hence thrombolysis in SSP. [6,33,45,51]…”

“…[1,2] Intravenous tissue plasminogen activator (IV rt-PA) is highly effective at reducing disability and improving outcomes. [3,4] Even though IV rt-PA utilization rates are increasing, [5,6] the overall utilization rates are far from optimal. The principal cause of non-use of IV rt-PA is delayed arrival time to the hospital.…”

Acute Stroke Through the Perspective of a County Hospital: Problems and Opportunities

“…Özellikle sürekli nitelikte şiddetli baş dönmesi ve kusma şikayeti ile başvuran hastalara nöroloji konsültasyonu istenmesi gerektiği ve şiddetli baş ağrısıyla başvuran gebe hastalarda preeklampsi/eklampsi ve migren haricinde serebral ven trombozu da görülebileceği, bu nedenle dikkatli bir nörolojik muayene yapılması gerektiği akılda tutulmalıdır. Atipik prezentasyonlar ve geçici iskemik atak gibi serebrovasküler olaylar hakkında acil servis çalışanlarına ve aile hekimlerine yönelik eğitimler düzenlenmesi bu konuda önemli faydalar sağlayabilir (20,21).…”

A Call for a Stroke Referral Network Between Primary Care and Stroke-Ready Hospitals in the Philippines

“…A checklist may aid EPs in accurately and safely identifying patients eligible to receive IVtPA among acute stroke patients 62. Development of a management course for EPs and emergency department-focused thrombolysis may also be feasible 63,64. However, it is worth noting that the pieces of evidence on the role of EPs and emergency medical services were generated from other settings; thus, studies carried out in the Philippines are still fundamental to corroborate their results.…”