Utilización de transporte sanitario urgente por los pacientes con ictus isquémico e impacto en los tiempos de atención

Arrate, A. Olascoaga; Guerrero, Mariana; Maiztegi, C. Fernández; Calle, I. Azkune; Fernández, Ricardo; Rodríguez, M. Fernández; Naveira, P. Vazquez; Elena, A. Anievas; González, I. Iturraspe; Díez, Y. Pérez; Fernández, Rafael Ruiz de Gopegui i

doi:10.1016/j.nrl.2016.11.004

Cited by 9 publications

(4 citation statements)

References 40 publications

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“…[18] A Spanish study determined the frequency and difference in time to definitive management between EMS and non-EMS-transported stroke patients. [17] EMS-transported patients underwent reperfusion strategies 3.7 times more frequently and had shorter onset to reperfusion times. In addition to decreased time to definitive management, EMS can also avoid secondary neuronal injury, namely hypoxia, hypotension and hypoglycaemia, which accelerate infarct progression.…”

Section: Articlementioning

confidence: 97%

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The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre

Crause¹,

Stassen²

2020

S Afr J Crit Care

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Sub-Saharan Africa (sSA) is experiencing an epidemiological transition caused by a combination of lifestyle and dietary changes, urbanisation, and demographic as well as social transitions. [1,2] The incidence and burden of non-communicable diseases and risk factors for cardiovascular disease are on the rise in most low-and middle-income countries (LMICs), including South Africa (SA). [2,3] The incidence of cardiovascular disease (CVD) in sSA is increasing significantly, and between 1990 and 2013 mortality rates associated with CVD increased by 81%. [3] In 2013 the largest proportion of deaths associated with CVD in sSA was attributed to stroke. [3] Globally, LMICs carry a disproportionately high CVD and stroke burden. [2,4] Hypertension (a risk factor for stroke) has an extremely high incidence in SA, where it largely remains poorly managed due to low awareness and poor compliance to treatment. [5] According to the 2016 South African Demographic and Health Survey, [6] 46% and 44% of SA women and men, respectively, above 15 years of age suffer from hypertension. In addition, a large proportion of the SA population suffer other risk factors, including tobacco use, obesity, diabetes and physical inactivity. [6,7] Therefore, stroke is one of the leading causes of mortality and lasting morbidity in SA, [7] leading to an estimated 25 000 deaths per year. [8] With an increase in stroke prevalence it is imperative to improve care of those affected. Stroke is extremely time sensitive and time to definitive management directly correlates to patient outcome. [9] Delays in treatment and transport to adequate treatment centres negatively affect patient outcome and lasting morbidity. [10] In contrast, early recognition, diagnosis and transport to adequate treatment facilities have been linked to improved patient outcome. [11] Stroke leads to cerebral infarct, and time increases risk of infarct progression to healthy tissue. [12,13] Further insult and secondary neuronal injury (such as hypoxia) can accelerate the progression of the infarct. [14] The only definitive management strategies for ischaemic stroke are reperfusion

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Section: Articlementioning

confidence: 97%

“…[9,12] A delay in recognition leads to a cascade of delays in hospital arrival, diagnostic testing and imaging, stroke evaluation and a delay to definitive management. [15,17] Therefore, it is crucial to improve early diagnosis of stroke and decrease time to definitive management at appropriate facilities.…”

Section: Articlementioning

confidence: 99%

The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre

Crause¹,

Stassen²

2020

S Afr J Crit Care

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“…The first step in delivering expeditious emergency care to patients suffering stroke is recognition. Delays in recognition impedes downstream events, ultimately resulting in delayed definitive treatment and the associated impact on morbidity and mortality [ 13 , 14 ]. Owing to poor patient education regarding stroke presentation, the call centre of emergency medical services (EMS) plays an important role towards early recognition [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The barriers and facilitators to the telephonic application of the FAST assessment for stroke in a private emergency dispatch centre in South Africa

Mackay

Theron

Stassen

2021

African Journal of Emergency Medicine

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“…To reduce the magnitude of deaths and disabilities, stroke chain of survival has been introduced which includes an early recognition of signs/symptoms of stroke, an activation of emergency medical service (EMS) with timely response, transport to stroke center with pre-arrival notification, and an implementation of guidelines on stroke care with high quality post-stroke rehabilitation [ 3 , 4 ]. Currently, several pieces of evidence indicate applying EMS system to the stroke care process can improve quality of management and decrease prehospital delays [ 5 – 7 ]. Therefore, the American Heart Association and the American Stroke Association (AHA/ASA) have introduced specific parameters to measure the quality of EMS care for stroke patients which include the highest level of care available for suspected stroke patients: dispatch time ≤ 60 s, activation time ≤ 60 s, response time (RT) ≤ 8 m, and on-scene time ≤ 15 m [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand

2021

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Background This work was to study the prehospital time among suspected stroke patients who were transported by an emergency medical service (EMS) system using a national database. Methods National EMS database of suspected stroke patients who were treated by EMS system across 77 provinces of Thailand between January 1, 2015, and December 31, 2018, was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance, and distance to the scene) and prehospital time (i.e., dispatch, activation, response, scene, and transportation time) were extracted. Time parameters were also categorized according to the guidelines. Results Total 53,536 subjects were included in the analysis. Most of the subjects were transported during 06.00-18.00 (77.5%) and were 10 km from the ambulance parking (80.2%). Half of the subjects (50.1%) were served by advanced life support (ALS) ambulance. Median total time was 29 min (IQR 21, 39). There was a significant difference of median total time among ALS (30 min), basic (27 min), and first responder (28 min) ambulances, Holm P = 0.009. Although 91.7% and 88.3% of the subjects had dispatch time ≤ 1 min and activation time ≤ 2 min, only 48.3% had RT ≤ 8 min. However, 95% of the services were at the scene ≤ 15 min. Conclusion Prehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min.

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Utilización de transporte sanitario urgente por los pacientes con ictus isquémico e impacto en los tiempos de atención

Abstract: EMS transport was associated with shorter prehospital delays. Effective health education programmes should be developed to promote EMS transport for patients with stroke symptoms. In-hospital stroke management should also be improved to reduce time to medical care.

Cited by 9 publications

References 40 publications

The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre

The accuracy of the FAST stroke assessment in identifying stroke at initial ambulance call into a South African private emergency call centre

The barriers and facilitators to the telephonic application of the FAST assessment for stroke in a private emergency dispatch centre in South Africa

Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand

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