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doi:10.22028/D291-39932
Titel: | Mobile Stroke Unit in the UK Healthcare System : Avoidance of Unnecessary Accident and Emergency Admissions |
VerfasserIn: | Grunwald, Iris Q. Phillips, Daniel J. Sexby, David Wagner, Viola Lesmeister, Martin Bachhuber, Monika Mathur, Shrey Guyler, Paul Fisher, James Perera, Saman Helwig, Stefan A. Schottek, Andrea Ewart, Ian Menon, Nisha Inam Ul Haq, Muhammad Grün, Daniel Merzou, Fatma Howard, Caroline Mapplebeck, Sarah Dommett, David Alam, Sajid Chakrabarti, Annie Gerry, Stephen Wiltshire, Chris Bailey, Marcus Bertsch, Thomas Foster, Theresa Davis, Tom Reith, Wolfgang Fassbender, Klaus Walter, Silke |
Sprache: | Englisch |
Titel: | Cerebrovascular Diseases |
Bandnummer: | 49 |
Heft: | 4 |
Seiten: | 388-395 |
Verlag/Plattform: | Karger |
Erscheinungsjahr: | 2020 |
Freie Schlagwörter: | Stroke Pre-hospital Mobile stroke unit Triage Large vessel occlusion Thrombolysis |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Background: Acute stroke patients are usually transported to the nearest hospital regardless of their required level of care. This can lead to increased pressure on emergency departments and treatment delay. Objective: The aim of the study was to explore the benefit of a mobile stroke unit (MSU) in the UK National Health Service (NHS) for reduction of hospital admissions. Methods: Prospective cohort audit observation with dispatch of the MSU in the East of England Ambulance Service area in Southend-on-Sea was conducted. Emergency patients categorized as code stroke and headache were included from June 5, 2018, to December 18, 2018. Rate of avoided admission to the accident and emergency (A&E) department, rate of admission directly to target ward, and stroke management metrics were assessed. Results: In 116 MSU-treated patients, the following diagnoses were made: acute stroke, n = 33 (28.4%); transient ischaemic attacks, n = 13 (11.2%); stroke mimics, n = 32 (27.6%); and other conditions, n = 38 (32.8%). Pre-hospital thrombolysis was administered to 8 of 28 (28.6%) ischaemic stroke patients. Pre-hospital diagnosis avoided hospital admission for 29 (25.0%) patients. As hospital treatment was indicated, 35 (30.2%) patients were directly triaged to the stroke unit, 1 patient (0.9%) even directly to the catheter laboratory. Thus, only 50 (43.1%) patients required transfer to the A&E department. Moreover, the MSU enabled thrombolysis with a median dispatch-to-needle time of 42 min (interquartile range, 40–60). Conclusion: This first deployment of an MSU in the UK NHS demonstrated improved triage decision-making for or against hospital admission and admission to the appropriate target ward, thereby reducing pressure on strained A&E departments. |
DOI der Erstveröffentlichung: | 10.1159/000508910 |
URL der Erstveröffentlichung: | https://doi.org/10.1159/000508910 |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-399320 hdl:20.500.11880/35938 http://dx.doi.org/10.22028/D291-39932 |
ISSN: | 1421-9786 1015-9770 |
Datum des Eintrags: | 9-Jun-2023 |
Bezeichnung des in Beziehung stehenden Objekts: | Supplementary Material |
In Beziehung stehendes Objekt: | https://figshare.com/ndownloader/files/24453140 |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Neurologie und Psychiatrie M - Radiologie |
Professur: | M - Prof. Dr. Klaus Faßbender M - Prof. Dr. Wolfgang Reith |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
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