scholarly journals P132: Development and implementation of an intubation registry within a Canadian tertiary-care hospital

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S122-S123
Author(s):  
J.H. Yoo ◽  
J. Trojanowski ◽  
M. Laberge ◽  
D. Griesdale ◽  
J.R. Brubacher
Keyword(s):  
Tertiary Care ◽  
Published Data ◽  
Preparation Technique ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Emergency Airway ◽  
Additional Information ◽  
Constructive Feedback ◽  
Abstract Submission ◽  
The Impact

Introduction: Intubation is a high-risk procedure that is frequently performed within the ED. Few Canadian centres have a system in place to monitor intubation frequency, indications, methods used, operator characteristics, first-pass success, and adverse event rates. There are no published data on the frequency of success or complications of emergency airway management in Canada. An airway registry would be a valuable quality improvement (QI) tool for assessing the impact of practice changes such as pre-intubation checklists and for identifying patients with “difficult airways.” We describe the development and implementation of an airway registry in a Canadian tertiary-care centre. Methods: We created a collaborative working group with staff from EM, ICU, Respiratory Therapy (RT), and Privacy. An airway data form was created. Over a 3 month trial period, the form was completed by RTs following each non-OR intubation. At our centre, RTs are present at every intubation outside of the OR. If a patient was intubated outside of the hospital, forms were completed using verbal handover. RTs also provided constructive feedback and after 3 months the form was revised and finalized. Medical student volunteers entered data from the forms and from chart reviews into a secure online database created for this purpose. Results: We have enrolled 373 patients over the first 5 months with ongoing enrolment at the time of abstract submission. The airway form captures the seniority and discipline of the intubator, preparation, technique, and any airway manoeuvres that were used. The form also captures Cormack-Lehane airway grading, confirmation techniques, complications, and the option to identify the patient as a “Difficult Airway.” Privacy permission was granted to include patient identifiers in the airway registry so that additional information from chart reviews could be obtained at a later date. Preliminary results will be presented at the conference. Conclusion: Our airway registry tracks intubation performance and may identify factors associated with adverse patient outcomes, which could prompt system-wide changes. Comparison of intubation performance to other Canadian institutions may be possible if similar airway registries are implemented. The development and implementation of an airway registry requires multi-disciplinary collaboration, engagement, and user feedback.

scholarly journals Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

2017 ◽  
Vol 6 (7) ◽  
pp. 2997
Author(s):  
Molina U. Patel ◽  
Yuvraj Jadeja ◽  
Niket Patel ◽  
Nayana Patel ◽  
Smruti Vaishnav ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

scholarly journals HEARING LOSS IN BLAST TRAUMA VICTIMS. A MULTICENTRE RETROSPECTIVE STUDY

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S130-35
Author(s):  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz Bhalli ◽  
Wasif Siddique ◽  
Attique Ahmed ◽  
Maryam Khan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tertiary Care ◽  
Case Series ◽  
Symptom Assessment ◽  
Tympanic Membrane Perforation ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Ear Injury ◽  
Blast Trauma ◽  
The Impact

Objective: To describe the resultant Otologic morbidity and report on the early outcomes following blasts occurring in twin cities of Quetta and Peshawar. Study Design: Case series. Place and Duration of Study: ENT department Tertiary Care Centre Quetta and Tertiary Care Hospital Peshawar. Study period was, from Jan 2013 to Dec 2013. Methodology: All bomb blast patients brought to the hospitals were included in study. Participants completed Symptom Assessment Forms followed by detailed ENT examination and Pure Tone Audiograms on arrival and after 6 weeks. Results: A total of 504 patients were included initially of which 80% of the patients were male. About 57.8% of the patients complained of ear injury, 21.6% of the total patients had tympanic membrane perforation on initial presentation. Chances of spontaneous closure of perforation were 20.9% in our study. Chances of hearing improvement were 17.9% in our study at the end of the study period. Conclusion: Blast related otologic injuries constituted a major source of morbidity The most common type of hearing loss following a blast trauma was mild to moderate conductive type. Chances of recovery of hearing following blast do exist (17.9%). Suspected patients should be regularly assessed and followed up. Much work needs to be done to study the impact of blast trauma on hearing in our country.

scholarly journals Identifying and Improving Knowledge Deficits of Emergency Airway Management of Tracheotomy and Laryngectomy Patients: A Pilot Patient Safety Initiative

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Ivan H. El-Sayed ◽  
Susan Ryan ◽  
Hildy Schell ◽  
Rosanne Rappazini ◽  
Steven J. Wang
Keyword(s):  
Airway Management ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Care Hospital ◽  
Cross Sectional ◽  
Respiratory Therapists ◽  
Emergency Airway ◽  
Emergent Airway Management ◽  
Knowledge Deficits ◽  
The Impact

Objectives. To evaluate the knowledge base of hospital staff regarding emergent airway management of tracheotomy and laryngectomy patients, and the impact of the introduction of a bedside airway form.Methods. Cross-sectional surveys of physicians, nurses, and respiratory therapists at a tertiary care hospital prior to and 24 months after introduction of a bedside Emergency Airway Access (EAA) form.Results. Pre- and postintervention surveys revealed several knowledge deficits. Preintervention, 37% of medical internists and 19% overall did not know that laryngectomy patients cannot be orally ventilated, and 67% of internists could not identify the purpose of stay sutures in recently created tracheotomies. Postintervention, these numbers improved for all groups. Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful.Conclusion. A knowledge deficit is identified in caregivers expected to provide emergency management of patients with airway anatomy altered by subspecialty surgeons. Safety initiatives such as the EAA form may improve knowledge among providers.

Impact of Blood Donor Clinic Closures on the Age of Blood Transfused In a Tertiary Care Centre

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4413-4413
Author(s):  
Christopher J. Patriquin ◽  
Cyrus C. Hsia ◽  
Ian H. Chin-Yee
Keyword(s):  
Blood Group ◽  
Outcome Measures ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
Categorical Variables ◽  
Published Data ◽  
Tertiary Care Centre ◽  
Storage Lesion ◽  
The Impact

Abstract Abstract 4413 INTRODUCTION: Red Blood Cells (RBCs) are stored for up to 42 days during which time multiple changes to the cells and media occur. This is collectively referred to as the “storage lesion.” Despite concern over the age of blood (AoB) transfused and the clinical impact of the storage lesion, there are no published data on the impact of donor clinic closures (DCCs) on the AoB transfused. In Canada, DCCs occur Sundays and statutory holidays and the Canadian Blood Services (CBS) can turn around products at the earliest within 24–48 hours. Thus regular DCCs could potentially affect the AoB transfused. METHODS: Data on all transfusions at London Health Sciences Centre (LHSC) between January 2006 and December 2008 were obtained. On average, LHSC issues approximately 25 000 RBC transfusions per year. Data included AoB and blood group for the transfused product, patient demographics, and admitting medical service. Dates for DCCs were obtained from CBS. Outcome measures included mean and variability of AoB transfused by day, month and year. Secondary outcome measures were the AoB transfused in relation to DCCs, and AoB transfused in various patient groups. Statistical analysis of categorical variables was analyzed with the Fisher's exact test and interval measures with the Student's t-test. RESULTS: A total of 67 449 transfusions were analyzed. The average AoB transfused was 20.5 days (d), with a range of 1 to 42 days. Greatest variation between days of the week was Tuesday and Saturday (20.7 vs 19.4d, p<0.001). Comparing Tuesday (2d post-DCC) and Sunday revealed significantly older blood issued on Tuesday (20.7 vs 19.5d, p<0.001). By month, the oldest blood was transfused in January (22.2d), the freshest in September (18.4d), with a difference of 3.8d (p<0.001). The year 2006 had the oldest AoB, 2007 the freshest (21.3 vs. 18.7d, D=2.6d, p<0.001). Analysis of the 5 days before and after holidays found that older blood was issued post-DCC for all holidays save New Year's Day. The oldest AoB by blood group was AB (31.3d), followed by B (25.8d), A (19.4d) and O (18.3d). Of the medical services, the newest transfusions were used by general surgery (19.2d), ICU (19.2d), and the ER (19.7d). CONCLUSION: The average AoB transfused was 20.5 days. Analysis of data by day of the week demonstrated similar AoB values. However, we did find AoB 2 days after regular DCCs was older than the days prior, as well as after all holiday DCCs except New Year's, likely due to two DCCs directly before it (Christmas Day and December 26). Analysis of AoB by blood group found the oldest blood to be AB, followed by B, A and O, corresponding with the national prevalence of ABO groups. One would expect a rarer group to have a smaller product pool from which to draw. Services using the freshest blood were surgery, ICU and ER, likely due to greater use of O units in resuscitation. Despite a trend of older RBCs being transfused in the period following DCCs the minor absolute differences observed are unlikely to represent a clinically significant impact for the recipient. Disclosures: No relevant conflicts of interest to declare.

Impact of Covid-19 on Surgical Training in a Tertiary Care Centre in Tirupati, Andhra Pradesh, India

2021 ◽  
Vol 8 (18) ◽  
pp. 1212-1216
Author(s):  
Roja Ramani Kumbha ◽  
Venkata Prakash Gandikota ◽  
Venkata Ramanaiah Nannam ◽  
Ganesh Reddy Elluru
Keyword(s):  
Surgical Training ◽  
Elective Surgery ◽  
Human Life ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Surgical Practice ◽  
The Future ◽  
The Impact

BACKGROUND Covid-19 pandemic has a devastating effect on many aspects of human life. The health care sector is the most affected, and surgical disciplines are no exception. Surgery has an essential role in human life, given its curative potential, and its dearth would cause much morbidity and even mortality in many cases. Surgery cannot wait even for a pandemic. Against this backdrop, it becomes essential to examine the effect of the pandemic on surgical disciplines. Here we study the impact of Covid-19 on the general surgery department in a tertiary care hospital. METHODS A retrospective observational study comparing data of outpatient department (OPD), admissions, and surgical activity in two different periods was done. RESULTS There was a significant impact on the number of surgical outpatients seen, admissions done, and surgeries conducted when compared between the two periods. In 2019 vs. 2020, 19,983 vs. 4481 OPD’s were seen. Similarly, 4274 admissions occurred during 2019 vs. only 506 in the 2020 period. Likewise, the impact on both elective and emergency surgery was also significant, 1102 elective surgeries were conducted in 2019. In contrast, Covid lead to complete cessation of elective surgery in 2020, increasing the risk of complication of various surgical conditions to the patients. Emergency surgeries in 2019, 694 vs. 220 in 2020 signified how the Covid pandemic had led human life to a standstill. Covid-19 pandemic resulted in abrupt cessation of various academic activities conducted in the department, but it also has seen the adoption of newer teaching methods. CONCLUSIONS Surgical care is quintessential in the fact that no other remedy can produce its results. There is no parallel. Lack of surgical care can lead to complications, avoidable morbidity, and mortality and can profoundly impact human life quality. Surgical education, which requires an apprenticeship, direct involvement, also took a hard hit, which has implications for future surgeons and patients alike. In this backdrop, our study highlights the need for more information on the future of surgical practices to make surgery safe in pandemic times. The existing lockdown had a significant impact on routine surgical practice and will require dedicated efforts for the resumption of "New Normal" in the future of all surgical disciplines. KEYWORDS Covid-19, Pandemic, Impact, Surgical Practice, Surgical Training

scholarly journals MP55: Characteristics associated with biphasic reactions in an adult population

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S62
Author(s):  
A. Lachance ◽  
M. Ben-shoshan ◽  
A. Cournoyer ◽  
R. Daoust ◽  
S. La Vieille ◽  
...  
Keyword(s):  
Adult Population ◽  
Tertiary Care ◽  
Initial Reaction ◽  
Care Hospital ◽  
Chi Square ◽  
Factors Associated ◽  
Additional Information ◽  
Initial Symptoms ◽  
Biphasic Reaction ◽  
The Impact

Introduction: Biphasic anaphylactic reactions are a concern in emergency medicine. Risk factors associated with this type of reaction remain ill-defined. The aim of this study was to investigate elements associated with biphasic anaphylactic reactions and to determine the impact of anaphylaxis treatments on biphasic reactions. Methods: From the multicenter Cross-Canada Anaphylaxis Registry prospective cohort, we selected adults (≥18 years) with a visit to the emergency department (ED) of Sacré-Cœur Hospital, an urban tertiary-care hospital. Then, a structured chart review was done to collect additional information on types and timing of treatments for the initial anaphylactic reaction, presence and treatment of biphasic reactions during the initial ED visit or upon patients’ return. Biphasic reactions were defined by the recurrence of any anaphylaxis symptoms within 72 hours of a resolved anaphylaxis episode. Potential factors associated with biphasic reactions were studied using Chi-Square and Mann-Whitney tests. Results: Patients with anaphylaxis were enrolled between April 2014 and February 2018. From the cohort, 401 adult patients were identified. We found 37 patients who developed a biphasic reaction. Amongst them, 33 received treatments and 9 required more than one dose of intramuscular epinephrine. None of the biphasic reaction patients required intravenous epinephrine, other vasopressors, ICU admission, or endotracheal intubation. Biphasic reactions appeared in a median time of 13.3h after the initial reaction ranging from 1.1h to 69.6h (IQR 30.2). There was no difference in age or gender of patients who developed a biphasic reaction compared those who did not. Pertinent past medical history, daily medications, mean of arrival to the ED, allergen type, ingestion route, or initial symptoms during the anaphylaxis episode were not significantly different in the two groups. Treatment with corticosteroids was similar in the two groups (9.0% vs. 8.1% p = 0.82). Treatment, dose and route of administration of epinephrine was not different in the two groups but longer delays before treatment with the first dose of epinephrine was more frequent in biphasic reaction patients (median delay of 64 minutes, p = 0.015). Conclusion: No patient characteristic, allergen, route of ingestion, symptom, nor treatment with corticosteroids has shown to be significantly different in patients with and without biphasic reactions. Delayed treatment with epinephrine is significantly associated with biphasic reactions.

IMPACT OF SOCIO-DEMOGRAPHIC VARIABLES AND MORBID CONDITIONS ON PERCEIVED MENTAL HEALTH COMPONENTS USING SF-36 QUESTIONNAIRE

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
S. K. Sharma ◽  
V. P. Shrotriya ◽  
D. Imtiaz ◽  
S. B. Gupta
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Social Functioning ◽  
Tertiary Care ◽  
Perceived Health ◽  
Subjective Assessment ◽  
Care Hospital ◽  
Sf 36 ◽  
The Social ◽  
The Impact

<bold>Introduction:</bold> Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. <bold>Material and Methods:</bold> Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. <bold>Results:</bold> The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p<0.001) but male gender (p>0.000) and higher income (p<0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. <bold>Conclusion:</bold> Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the study’s limitations.

scholarly journals Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lamis R. Karaoui ◽  
Elsy Ramia ◽  
Hanine Mansour ◽  
Nisrine Haddad ◽  
Nibal Chamoun
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Bleeding Event ◽  
Transitions Of Care ◽  
Control Group ◽  
Published Data ◽  
Post Discharge ◽  
Readmission Rates ◽  
The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

scholarly journals Impact of Rapid PCR Influenza Testing on the Rate of Inpatient Admissions During Influenza Season at a Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  
Keyword(s):  
Influenza Season ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Turnaround Time ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Rapid Pcr ◽  
The Impact

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None

scholarly journals Impact of COVID-19 pandemic on stroke admissions in Qatar

2021 ◽  
Vol 3 (1) ◽  
pp. e000084
Author(s):  
Naveed Akhtar ◽  
Salman Al Jerdi ◽  
Ziyad Mahfoud ◽  
Yahia Imam ◽  
Saadat Kamran ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Small Vessel Disease ◽  
Tertiary Care ◽  
Relative Increase ◽  
Large Vessel ◽  
Tertiary Care Centre ◽  
Transient Ischaemic Attacks ◽  
Stroke Mimics ◽  
Coronary Syndromes ◽  
The Impact

IntroductionThe COVID-19 pandemic has resulted in a dramatic unexplained decline in hospital admissions due to acute coronary syndromes and stroke. Several theories have emerged aiming to explain this decline, mostly revolving around the fear of contracting the disease and thus avoiding hospital visits.AimsIn this study, we aim to examine the impact of the COVID-19 pandemic on stroke admissions to a tertiary care centre in Qatar.MethodsThe Hamad General Hospital stroke database was interrogated for stroke admissions between September 2019 and May 2020. The number of stroke admissions, stroke subtypes and short-term outcomes was compared between the ‘pre-COVID-19’ period (September 2019 to February 2020) and the COVID-19 pandemic period (March to May 2020).ResultsWe observed a significant decline in monthly admissions in March (157), April (128) and May (135) compared with the pre-COVID-19 6-month average (229) (p=0.024). The reduction in admissions was most evident in functional stroke mimics. The average admissions decreased from 87 to 34 per month (p=0.0001). Although there were no significant differences in admissions due to ischaemic stroke (IS), intracranial haemorrhage or transient ischaemic attacks between the two periods, we noted a relative decrease in IS due to small vessel disease and an increase in those due to large vessel atherosclerosis in March to May 2020.ConclusionsThe decline in overall stroke admissions during the COVID-19 pandemic is most likely related to concerns of contracting the infection, evidenced mainly by a decline in admissions of stroke mimics. However, a relative increase in large vessel occlusions raises suspicion of pathophysiological effects of the virus, and requires further investigation.

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