Management of ischemic stroke: Part 1. Emergency room management

2010 ◽  
Vol 5 (1) ◽  
pp. 33-40
Author(s):  
Christine Lu-Emerson ◽  
David Likosky ◽  
Alpesh Amin ◽  
David Tirschwell
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Emergency Room Management

scholarly journals Analysis of the costs of emergency room management of critically ill patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Gabriele Valli ◽  
Paolo Fratini ◽  
Nicola Volpe ◽  
Francesca De Marco ◽  
Caterina Pandolfi ◽  
...  
Keyword(s):  
Emergency Room ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Emergency Room Management

Abstract P311: Outpatient Evaluation of Transient Ischemic Attack and Minor, Non-Disabling Stroke During the COVID-19 Pandemic

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Paul Wechsler ◽  
Babak B Navi ◽  
Alan Z Segal ◽  
Neal S Parikh ◽  
Halina White
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Median Time ◽  
Symptom Onset ◽  
Transient Global Amnesia ◽  
Patient Characteristics ◽  
Quality Data ◽  
Minor Stroke ◽  
Laboratory Diagnostics ◽  
Global Amnesia

Introduction: Reductions in hospital visits for stroke have been seen during the COVID-19 pandemic, partly reflecting perceived risks of in-hospital care. We recently implemented an evidence-based protocol for outpatient rapid evaluation of transient and minor, non-disabling stroke symptoms for patients seeking care 24 hours after symptom onset. We present our early experience through the pandemic. Methods: We conducted a retrospective review of patients evaluated in the RESCUE-TIA ( R apid E valuation of minor S troke and C erebrovasc U lar E vents including TIA ) clinic from December 2019-August 2020. The clinic sees patients with TIA symptoms or with fixed, non-disabling deficits seeking care > 24 hours after symptom onset. We introduced telemedicine in March 2020. Magnetic resonance brain and vascular imaging is available within 24 hours of visit. We summarized patient characteristics and quality data with standard descriptive statistics. Results: A total of 21 patients were seen in the RESCUE-TIA clinic, including 15 patients during the height of the pandemic in NY; 67% were seen by telemedicine. The median age was 75 years (interquartile range [IQR], 61-82), and 71% were women. The median NIH Stroke Score for patients with minor stroke was 0 (IQR, 0-1), and the median ABCD 2 score for TIA patients was 3 (IQR, 2-3). Median time from symptom onset to evaluation was 3 days (IQR, 2.5-17.5). Median time from evaluation to laboratory diagnostics was 8 hours (IQR, 2-21), and to completion of imaging was 1 day (IQR, 0-5). Outpatient telemetry commenced in a median of 5 days (IQR, 1-9), and echocardiography was completed in a median of 8 days (IQR, 0-10). One patient was referred to the emergency room for a carotid occlusion. Final diagnoses were TIA (n=12), ischemic stroke (n=5), transient global amnesia (n=2), migraine (n=1), and non-aneurysmal, distal subarachnoid hemorrhage (n=1). Secondary prevention was initiated or optimized in 94% of TIA and stroke patients. Recurrent TIA occurred in 1 patient after 67 days, and ischemic stroke occurred in 1 patient 55 days after TIA. Conclusion: Timely outpatient evaluation of patients with recent TIA and minor, non-disabling stroke is feasible and may be useful during the pandemic, especially during emergency room crowding.

Risk of Ischemic Stroke after an Inpatient Hospitalization for Transient Ischemic Attack in the United States

2020 ◽  
pp. 1-7
Author(s):  
Aayushi Garg ◽  
Kaustubh Limaye ◽  
Amir Shaban ◽  
Enrique C. Leira ◽  
Harold P. Adams
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Transient Ischemic Attack ◽  
Previous History ◽  
The United States ◽  
Charlson Comorbidity Index Score ◽  
Inpatient Hospitalization ◽  
Discharge Disposition ◽  
Cardiovascular Comorbidities ◽  
Ischemic Attack

<b><i>Introduction:</i></b> A diagnosis of transient ischemic attack (TIA) must be followed by prompt investigation and rapid initiation of measures to prevent stroke. Prior studies evaluating the risk of stroke after TIA were conducted in the emergency room or clinic settings. Experience of patients admitted to the hospital after a TIA is not well known. We sought to assess the early risk of ischemic stroke after inpatient hospitalization for TIA. <b><i>Methods:</i></b> We used the 2010–2015 Nationwide Readmissions Database to identify all hospitalizations with the primary discharge diagnosis of TIA and investigated the incidence of ischemic stroke readmissions within 90 days of discharge from the index hospitalization. <b><i>Results:</i></b> Of 639,569 index TIA admissions discharged alive (mean ± SD age 70.4 ± 14.4 years, 58.7% female), 9,131 (1.4%) were readmitted due to ischemic stroke within 90 days. Male sex, head/neck vessel atherosclerosis, hypertension, diabetes, atrial flutter/fibrillation, previous history of TIA/stroke, illicit drug use, and higher Charlson Comorbidity Index score were independently associated with readmissions due to ischemic stroke. Ischemic stroke readmissions were associated with excess mortality, discharge disposition other than to home, and elevated cost. <b><i>Conclusions:</i></b> Patients hospitalized for TIA have a lower risk of ischemic stroke compared to that reported in the studies based on the emergency room and/or outpatient clinic evaluation. Among these patients, those with cardiovascular comorbidities remain at a higher risk of readmission due to ischemic stroke despite undergoing an inpatient evaluation and should therefore be the target for future preventive strategies.

Radiological emergency room management with emphasis on multidetector-row CT

2003 ◽  
Vol 48 (1) ◽  
pp. 2-4 ◽  
Author(s):  
M.O. Philipp ◽  
K. Kubin ◽  
M. Hörmann ◽  
V.M. Metz
Keyword(s):  
Emergency Room ◽  
Emergency Room Management ◽  
Multidetector Row Ct ◽  
Radiological Emergency ◽  
Multidetector Row

Emergency room management of patients with sore throats in a teaching hospital: Influence of non-physician factors

1976 ◽  
Vol 1 (3) ◽  
pp. 196-204 ◽  
Author(s):  
Suzanne W. Fletcher ◽  
Claus Hamann
Keyword(s):  
Emergency Room ◽  
Teaching Hospital ◽  
Emergency Room Management

scholarly journals The validity of recognition of stroke in the emergency room (ROSIER) scale in the diagnosis of Iranian patients with acute ischemic stroke in the emergency department

2021 ◽  
Vol 21 (1) ◽  
pp. 1
Author(s):  
Alireza Baratloo ◽  
Mahdi Zangi ◽  
Somayeh Karimi ◽  
Sahar Mirbaha ◽  
Mehran Sotoodehnia ◽  
...  
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Emergency Room ◽  
Acute Ischemic Stroke ◽  
Iranian Patients
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