Emergency Department Companions of Stroke Patients

Ashkenazi, Liat; Toledano, Ronen; Novack, Victor; EIluz, Esther; Abu-Salamae, Ibrahim; Ifergane, Gal

doi:10.1097/md.0000000000000520

Cited by 12 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This corresponds with our findings on the perceived seriousness of the situation in patients and bystanders. In line with our study, some studies have found that bystander presence increases the use of EMS, 27–29 and others have also found an association to reduced prehospital delay. 7,10,29 However, the role of the bystander and the patient’s type of social network may play an important role, as smaller social networks (e.g.…”

Section: Discussionsupporting

confidence: 92%

Understanding the seriousness of a stroke is essential for appropriate help-seeking and early arrival at a stroke centre: A cross-sectional study of stroke patients and their bystanders

Iversen

Blauenfeldt

Johnsen

et al. 2020

European Stroke Journal

View full text Add to dashboard Cite

Introduction Only a minority of patients with acute ischaemic stroke receive reperfusion treatment, primarily due to prehospital delay. We aimed to investigate predictors of a primary contact to the emergency medical services, arrival at stroke centre within 3 h of symptom onset and initiation of reperfusion therapy in patients with acute stroke. Patients and methods We conducted a cross-sectional study of consecutive patients with acute ischaemic stroke, intracerebral haemorrhage or transient ischaemic attack. Structured interviews of patients and bystanders were performed and combined with clinical information from the Danish Stroke Registry. Eligible patients were aged ≥18 years and were independent in activities of daily living before the stroke. Results We included 435 patients. Presence of a bystander at symptom onset and knowledge of ≥2 core symptoms of stroke were associated with a primary emergency medical services contact. Higher stroke severity and patients or bystanders perceiving the situation as very serious were associated with a primary emergency medical services contact (ORpatients 2.10; 95% CI 1.12–3.95 and ORbystanders 22.60; 95% CI 4.98–102.67), <3 h from onset to arrival (ORpatients 3.01; 95% CI 1.46–6.21 and ORbystanders 4.44; 95% CI 1.37–14.39) and initiation of reperfusion therapy (ORpatients 3.08; 95% CI 1.23–7.75 and ORbystanders 4.70; 95% CI 1.14–19.5). Conclusion: Having a bystander, knowledge of ≥2 core symptoms and understanding that stroke is a serious event are associated with appropriate help-seeking behaviour, shorter prehospital delay and higher chance of reperfusion therapy in acute stroke patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Understanding the seriousness of a stroke is essential for appropriate help-seeking and early arrival at a stroke centre: A cross-sectional study of stroke patients and their bystanders

Iversen

Blauenfeldt

Johnsen

et al. 2020

European Stroke Journal

View full text Add to dashboard Cite

show abstract

“…Subsequent iterations of the MSU have adapted to their respective settings. Larger vehicles have the advantage of carrying larger scanners and more specialized personnel, robustness in rural off-road conditions, and allowing relatives to accompany patients to provide history and procedural consent (79). Smaller vehicles may have greater access to narrow roads and lower cost.…”

Section: Adapting Msu Approaches To Rural Healthcarementioning

confidence: 99%

Improving Prehospital Stroke Services in Rural and Underserved Settings With Mobile Stroke Units

et al. 2019

View full text Add to dashboard Cite

In acute stroke management, time is brain, as narrow therapeutic windows for both intravenous thrombolysis and mechanical thrombectomy depend on expedient and specialized treatment. In rural settings, patients are often far from specialized treatment centers. Concurrently, financial constraints, cutting of services and understaffing of specialists for many rural hospitals have resulted in many patients being underserved. Mobile Stroke Units (MSU) provide a valuable prehospital resource to rural and remote settings where patients may not have easy access to in-hospital stroke care. In addition to standard ambulance equipment, the MSU is equipped with the necessary tools for diagnosis and treatment of acute stroke or similar emergencies at the emergency site. The MSU strategy has proven to be effective at facilitating time-saving stroke triage decisions. The additional on-board imaging helps to determine whether a patient should be taken to a primary stroke center (PSC) for standard treatment or to a comprehensive stroke center (CSC) for advanced stroke treatment (such as intra-arterial therapy) instead. Diagnosis at the emergency site may prevent additional in-hospital delays in workup, handover and secondary (inter-hospital) transport. MSUs may be adapted to local needs—especially in rural and remote settings—with adjustments in staffing, ambulance configuration, and transport models. Further, with advanced imaging and further diagnostic capabilities, MSUs provide a valuable platform for telemedicine (teleradiology and telestroke) in these underserved areas. As MSU programmes continue to be implemented across the world, optimal and adaptable configurations could be explored.

show abstract

“…In the case of stroke, patients with a companion during a medical visit are about 1.7 times more likely to have than older adults without stroke (Price et al, 2019). Research from Ashkenazi et al suggests that family members and other companions could facilitate faster and more effective emergency department (ED) management of stroke patients, possibly improving their outcomes (Ashkenazi et al, 2015). Besides, information from companions can be used to assess the quality of life when patients are incapable of reporting their condition (Medea et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Patients and Their Companion Perception about Disease and How to Communicate to Medical Practitioners

Ganiem

Komalawati²,

Pandjaitan³

et al. 2022

J. Komun.

View full text Add to dashboard Cite

Understanding the patient's and companion's perception of the patient's illness can improve the patient's compliance and overall satisfaction. Patients' understanding of their illness is essential for recovery. Doctors should understand the perceptions and interpretations about the illness, experience, knowledge and culture of patients and their companions. The disease is what happens to the patient. Arthur Kleinman's Explanatory Model of Illness provides a guide for understanding the patient's point of view. The purpose of this study was to explore the meaning of stroke experienced by patients, according to the point of view of the patient and his companion, and the treatment they had, second, to explore how the patient and the companion convey the condition to the doctor. The method uses a phenomenological approach through interviews, observations, and secondary patient data. There are two primary informants, namely two patients and two companions. This study's results indicate a gap regarding the meaning of the disease between the patient's conception and the health sciences. Patients' and their companion's perceptions denote the economic, social, and political background in terms of the patient's illness. The information that patient and companion convey to doctors, usually do not whole information about what they have done during the journey of treatment. Models for interaction that are mainly developed are between doctor and patient. For effective communication between doctor and companion to help the patient better, there is an important model for consultation that includes triadic communication: doctor-patient-companion which can be advantageous. Important also for the doctor to upgrade the knowledge about understanding not only biomedical information but also the socio, psycho, cultural, and religion of the patient.

show abstract

Emergency Department Companions of Stroke Patients

Cited by 12 publications

References 12 publications

Understanding the seriousness of a stroke is essential for appropriate help-seeking and early arrival at a stroke centre: A cross-sectional study of stroke patients and their bystanders

Understanding the seriousness of a stroke is essential for appropriate help-seeking and early arrival at a stroke centre: A cross-sectional study of stroke patients and their bystanders

Improving Prehospital Stroke Services in Rural and Underserved Settings With Mobile Stroke Units

Patients and Their Companion Perception about Disease and How to Communicate to Medical Practitioners

Contact Info

Product

Resources

About