Door to thrombolysis:: ER reorganization and reduced delays to acute stroke treatment

被引：133

作者：

Lindsberg, P. J.

Haeppoelae, O.

Kallela, M.

Valanne, L.

Kuisma, M.

Kaste, M.

机构：

[1] Univ Helsinki, Cent Hosp, Dept Neurol, FIN-00014 Helsinki, Finland

[2] Univ Helsinki, Cent Hosp, Dept Radiol, FIN-00014 Helsinki, Finland

[3] Univ Helsinki, Cent Hosp, Program Neurosci, FIN-00014 Helsinki, Finland

[4] Univ Helsinki, Cent Hosp, Biomedicum, Helsinki Emergency Med Serv, FIN-00014 Helsinki, Finland

来源：

NEUROLOGY | 2006年 / 67卷 / 02期

基金：

芬兰科学院;

关键词：

D O I：

10.1212/01.wnl.0000224759.44743.7d

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The authors reorganized the emergency room (ER) by moving CT to the ER and streamlining triage by prenotification by emergency medical services (EMS), which reduced in-hospital delays and enhanced access to stroke thrombolysis. CT delay dropped from 1 hour 3 minutes +/- 14 minutes in 1999 to 7 +/- 2 minutes in 2004 (p < 0.0001). Door-to-needle time dropped from 1 hour 28 minutes +/- 7 minutes to 50 +/- 3 minutes (p < 0.001), while symptom-to-needle time dropped from 2 hours 44 minutes +/- 6 minutes to 2 hours 5 minutes +/- 4 minutes (p < 0.0001). From 23 patients in 1999, thrombolysis access was increased to 100 patients in 2004 and 183 patients in 2005.

引用

收藏

页码：334 / 336

页数：3

相关论文

共 10 条

[1] EFFECTS OF PUBLIC AND PROFESSIONAL-EDUCATION ON REDUCING THE DELAY IN PRESENTATION AND REFERRAL OF STROKE PATIENTS [J].

ALBERTS, MJ ;

PERRY, A ;

DAWSON, DV ;

BERTELS, C .

STROKE, 1992, 23 (03) :352-356

[2] Therapeutic yield and outcomes of a community teaching hospital code stroke protocol [J].

Asimos, AW ;

Norton, HJ ;

Price, MF ;

Cheek, WM .

ACADEMIC EMERGENCY MEDICINE, 2004, 11 (04) :361-370

[3] Prehospital and in-hospital delays in acute stroke care [J].

Evenson, KR ;

Rosamond, WD ;

Morris, DL .

NEUROEPIDEMIOLOGY, 2001, 20 (02) :65-76

[4]

Jahnke Heidi K, 2003, J Emerg Nurs, V29, P133, DOI 10.1067/men.2003.85

[5] Improving the efficiency of delivery of thrombolysis for acute stroke: a systematic review [J].

Kwan, J ;

Hand, P ;

Sandercock, P .

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2004, 97 (05) :273-279

[6] Community-based thrombolytic therapy of acute ischemic stroke in Helsinki [J].

Lindsberg, PJ ;

Soinne, L ;

Roine, RO ;

Salonen, O ;

Tatlisumak, T ;

Kallela, M ;

Häppölä, O ;

Tiainen, M ;

Haapaniemi, E ;

Kuisma, M ;

Kaste, M .

STROKE, 2003, 34 (06) :1443-1449

[7] Improving delivery of acute stroke therapy - The TLL Temple Foundation Stroke Project [J].

Morgenstern, LB ;

Staub, L ;

Chan, WY ;

Wein, TH ;

Bartholomew, LK ;

King, M ;

Felberg, RA ;

Burgin, WS ;

Groff, J ;

Hickenbottom, SL ;

Saldin, K ;

Demchuk, AM ;

Kalra, A ;

Dhingra, A ;

Grotta, JC .

STROKE, 2002, 33 (01) :160-166

[8] Prehospital and emergency department delays after acute stroke - The Genentech Stroke Presentation Survey [J].

Morris, DL ;

Rosamond, W ;

Madden, K ;

Schultz, C ;

Hamilton, S .

STROKE, 2000, 31 (11) :2585-2590

[9] Pre- and in-hospital delays from stroke onset to intra-arterial thrombolysis [J].

Nedeltchev, K ;

Arnold, M ;

Brekenfeld, C ;

Isenegger, J ;

Remonda, L ;

Schroth, G ;

Mattle, HP .

STROKE, 2003, 34 (05) :1230-1234

[10] Activation of emergency medical services for acute stroke in a nonurban population - The TLL Temple Foundation Stroke Project [J].

Wein, TH ;

Staub, L ;

Felberg, R ;

Hickenbottom, SL ;

Chan, WY ;

Grotta, JC ;

Demchuk, AM ;

Groff, J ;

Bartholomew, LK ;

Morgenstern, LB .

STROKE, 2000, 31 (08) :1925-1928