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A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service

Artikel i vetenskaplig tidskrift
Författare M. A. Hagiwara
B. W. Sundstrom
P. Brink
J. Herlitz
Per-Olof Hansson
Publicerad i Acta Neurologica Scandinavica
Volym 137
Nummer/häfte 5
Sidor 523-530
ISSN 0001-6314
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 523-530
Språk en
Länkar dx.doi.org/10.1111/ane.12895
Ämnesord EMS, prehospital, stroke, system delay, association, management, decision, times, care, Neurosciences & Neurology
Ämneskategorier Neurologi

Sammanfattning

ObjectivesWe compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methodsThe Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. ResultsOf 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. ConclusionsPatients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.

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