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Titolo:
Deployment of emergency physicians for patients with stroke in the Munsterarea: a cross-sectional study of the quality of medical care in one region
Autore:
Weltermann, B; vom Eyser, D; Kleine-Zander, R; Riedel, T; Dieckmann, J; Ringelstein, EB;
Indirizzi:
Univ Munster, Neurol Klin & Poliklin, D-48129 Munster, Germany Univ Munster Munster Germany D-48129 Poliklin, D-48129 Munster, Germany Berufsfeuerwehr Stadt Munster, Munster, Germany Berufsfeuerwehr Stadt Munster Munster Germany Munster, Munster, Germany
Titolo Testata:
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT
fascicolo: 41, volume: 124, anno: 1999,
pagine: 1192 - 1196
Fonte:
ISI
Lingua:
GER
Soggetto:
ACUTE ISCHEMIC STROKE; HYPERTENSION; MANAGEMENT; COMMUNITY; DIAGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Weltermann, B Univ Munster, Inst Epidemiol & Sozialmed, Domagkstr 3, D-48129 Munster, Germany Univ Munster Domagkstr 3 Munster Germany D-48129 r, Germany
Citazione:
B. Weltermann et al., "Deployment of emergency physicians for patients with stroke in the Munsterarea: a cross-sectional study of the quality of medical care in one region", DEUT MED WO, 124(41), 1999, pp. 1192-1196

Abstract

Background and objective: Advances in understanding the pathophysiology and treatment of stroke have led to changed requirements, including the prehospital phase, for the care of patients with acute stroke. Rapid transport to a regional stroke centre is nowadays considered to be the standard for optimal quality of care. A retrospective cross-sectional analysis was undertaken in 1996 in the region of the town of Munster to test the quality of medical care provided by physicians on emergency call. Patients and methods: 250 of 3001 protocols (8.3%) filled in by emergency call physicians were selected in which the initial diagnosis of transitory ischaemic attack, stroke or cerebral haemorrhage had been made. Quality of patient care was assessed according to the following criteria; (1) completemedical treatment (blood sugar, blood pressure, cardiac rhythm and arterial oxygen saturation, including relevant treatment of any abnormality) (2) action time (arrival of emergency doctor within 12 min and arrival at hospital within 50 min); (3) type of the admission hospital (stroke centre defined as a hospital experienced in the treatment of stroke, with neurological and medical departments, as well as 24-hour cover for computed cranial tomography). A summated indicator of >>optimal care<< was used to determine whether the three stated criteria were met. Results: Mean age of the stroke patients was 72.3 years. While the above mentioned quality criteria for the action time were met in 93.5% of patients, only 56.0% were admitted to a stroke centre, and this was significantly more often the final destination for patients under the age of 65 years thanfor older ones (p = 0.049). The quality indicator >>complete medical treatment<< was met for 27.2% of the transported patients. Measured according topresent-day criteria, only 18.6% of patients received such optimal treatment. Conclusion. This analysis indicates that modern prehospital treatment of stroke patients does not reach adequate standards. In particular, it is not comprehensive. While the >>action time<< is usually adequate, there are deficiencies regarding the quality of medical care and the choice of the admission hospital. Further education far emergency physicians with respect to the management of stroke syndrome should be an integral part of any regionalquality programme. The number of hospitals with adequate competence in theacute management of stroke cases is still insufficient.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/21 alle ore 02:05:34