Large Vessel Occlusion Stroke Detection in the Prehospital Environment.

IF 1.4 Q3 EMERGENCY MEDICINE Current Emergency and Hospital Medicine Reports Pub Date : 2021-09-01 Epub Date: 2021-06-28 DOI:10.1007/s40138-021-00234-9
Lauren Patrick, Wade Smith, Kevin J Keenan
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引用次数: 7

Abstract

Purpose of review: Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.

Recent findings: Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients.

Summary: The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.

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院前环境中大血管闭塞卒中检测。
回顾目的:血管内治疗继发于大血管闭塞(LVO)的急性缺血性卒中是时间依赖性的。院前疑似左心室卒中的患者应直接分流到专门的卒中中心进行血管内治疗。本文综述了院前疑似脑卒中患者LVO检测的进展。最近的发现:临床院前卒中严重程度工具已在院前环境中得到验证。包括脑电图、ssep、TCD、颅加速度计和体积阻抗相移光谱在内的设备最近发表了关于医院环境中LVO检测的数据。移动脑卒中单元为患者带来溶栓和血管成像。摘要:院前卒中严重程度工具用于LVO分诊现已得到广泛支持。应优先考虑易用性,因为不同工具之间的诊断性能没有显著差异。LVO诊断设备很有前景,但尚未在院前环境中得到验证。流动卒中单元改善了患者的治疗效果,成本效益分析正在进行中。
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期刊介绍: This journal aims to offer expert review articles on the most significant recent developments in emergency and hospital medicine, with particular emphasis on the transition of patient care from the emergency department to the hospitalist service. By providing clear, insightful, balanced contributions, the journal intends to serve 1) those who provide immediate medical attention to patients with acute injuries or conditions in emergency departments and emergency medical service settings, and 2) hospitalists who deliver comprehensive medical care in collaboration with physicians and other health care personnel responsible for hospitalized patients. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include acute coronary syndrome; chronic obstructive pulmonary disease; community-acquired infections; diabetes and metabolic disease; heart failure; hospital-acquired infections; pharmacology of acute care; shared practice and economic issues; and thrombosis.
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