Prehospital assessment of stroke: time is brain

Rae, Victoria; Ford, Gary; Price, Christopher

doi:10.12968/jpar.2011.3.9.483

Cited by 4 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of screening tests have been developed to identify patients at high risk of stroke. Early transportation of the patient to the hospital allows thrombolysis to be administered and improves prognosis for the final outcome of the disease [54].…”

Section: Cт Angiography and Digital Subtraction Angiographymentioning

confidence: 99%

Diagnostic Imaging of Carotid Artery

Manchev¹

2018

Carotid Artery - Gender and Health [Working Title]

View full text Add to dashboard Cite

In the study of carotid arteries, the different imaging techniques allow to analyze various diseases like stenoses, aneurysms, thromboses, dissections, diseases caused by atherosclerotic plaques or congenital abnormalities. The diagnostic modalities that are used to image the carotid artery diseases are digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The goal of the diagnostic imaging is to provide screening and to detect diseases at its earliest and most treatable stage. As initial screening study, the radiologists recommend DUS. It is a safe and painless way to produce pictures of the inside of the body using sound waves. It assesses blood flow in the carotid arteries, measures the speed of the blood flow, and estimates the diameter of a blood vessel and degree of obstruction. Digital subtraction angiography (DSA) has assumed a major role in the evaluation of occlusive cerebrovascular disease. While digital subtraction angiography (DSA) is still considered the gold standard, it has increasingly been replaced by computed tomography angiography (CTA) or magnetic resonance angiography (MRA) during the last years. Modern imaging studies like CTA and MRI allow to obtain three-dimensional reconstruction of anatomic structures and pathological abnormalities. Computed tomography angiography (CTA) of carotid arteries is a standardized procedure with excellent image quality but related with high radiation exposure. The rapid technical evolution in hardware and software allows even smaller imaging centers to perform high-quality vessel imaging. During the last decade, CTA came up with substantial progress in terms of accuracy in stenosis and aneurysm detection. Magnetic resonance angiography (MRA) is increasingly used as a noninvasive method to assess carotid arteries. Diseases like carotid artery dissections could be detected by using MRA or CTA.

show abstract

Section: Cт Angiography and Digital Subtraction Angiographymentioning

confidence: 99%

Diagnostic Imaging of Carotid Artery

Manchev¹

2018

Carotid Artery - Gender and Health [Working Title]

View full text Add to dashboard Cite

show abstract

Referral pathways for patients with TIA avoiding hospital admission: a scoping review

et al. 2017

View full text Add to dashboard Cite

ObjectiveTo identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital.DesignScoping review.Data sourcesPubMed, CINAHL Web of Science, Scopus.Study selectionReports of primary research on referral of patients with suspected TIA directly to specialist outpatient services.Data extractionWe screened studies for eligibility and extracted data from relevant studies. Data were analysed to describe setting, assessment and referral processes, treatment, implementation and outcomes.Results8 international studies were identified, mostly cohort designs. 4 pathways were used by family doctors and 3 pathways by emergency department physicians. No pathways used by paramedics were found. Referrals were made to specialist clinic either directly or via a 24-hour helpline. Practitioners identified TIA symptoms and risk of further events using a checklist including the ABCD2 tool or clinical assessment. Antiplatelet medication was often given, usually aspirin unless contraindicated. Some patients underwent tests before referral and discharge. 5 studies reported reduced incident of stroke at 90 days, from 6–10% predicted rate to 1.3–2.1% actual rate. Between 44% and 83% of suspected TIA cases in these studies were referred through the pathways.ConclusionsResearch literature has focused on assessment and referral by family doctors and ED physicians to reduce hospitalisation of patients with TIA. No pathways for paramedical use were reported. We will use results of this scoping review to inform development of a paramedical referral pathway to be tested in a feasibility trial.Trial registration numberISRCTN85516498. Stage: pre-results.

show abstract

The decision-making process in an emergency: a reflection on paramedic practice

Lindsey

2013

Journal of Paramedic Practice

View full text Add to dashboard Cite

This article will use a case study to critically reflect and analyse the decision-making process used in an emergency situation. It will discuss a range of factors that influenced the clinical decision-making process and how this prompted immediate transport to a local hospital. A wide range of supporting evidence will be explored and the decision-making process will be questioned and challenged. Relevant professional, ethical and legal issues will be considered and discussed. The inclusion of other colleagues, patients, relatives and their involvement, within the decision-making process, will also be deliberated.

show abstract

Prehospital assessment of stroke: time is brain

Cited by 4 publications

References 23 publications

Diagnostic Imaging of Carotid Artery

Diagnostic Imaging of Carotid Artery

Referral pathways for patients with TIA avoiding hospital admission: a scoping review

The decision-making process in an emergency: a reflection on paramedic practice

Contact Info

Product

Resources

About