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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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