脑卒中的早期识别和处理精编版.ppt

尽早动脉瘤栓塞术 脑血管病的社会系统工程 增强公众意识 迅速转运至医院 急诊室快速评估 评价、诊断、治疗 门诊治疗 二期预防 门诊康复 家庭参与 卒中单元 继续照顾 家庭 社区 * * * Emergency Medical Services Response In the care of acute stroke patients, the speed and appropriateness of actions taken by the emergency medical services (EMS) can make the difference not only between life and death, but also between disability and functional recovery. There is consensus that the aim should be to achieve hospital admission within 60 minutes of symptom onset although, in practice, this may only be possible in densely populated urban areas with suitable hospitals.1 A goal of 180 minutes has been suggested for suburban and rural areas.1 In the management of stroke patients, it is established that using the emergency services as the primary contact (rather than ringing the family doctor, for example) can significantly reduce time to admission.2 Systems of this sort are already used widely in the US and are also used regionally in parts of some European countries, such as Germany and Finland. The preliminary examination and provisional diagnosis is made at the prehospital stage and the transporting team relays news of the pending arrival of an acute stroke patient to the nearest appropriate hospital department.1 Early notification that a stroke patient is en route may save valuable time after arrival at hospital: it enables the mobilisation of appropriate personnel and equipment ready to attend the patient immediately.3 In myocardial infarction, prehospital identification of patients combined with early notification of arrival has been found to reduce the time to thrombolytic treatment by up to 75 minutes.4 In stroke, it has been estimated that a similar approach could provide up to 60 minutes of valuable time to prepare for the patient’s arrival.4 References 1. European Ad Hoc Consensus Group. European strategies for early intervention in stroke: a report of an Ad Hoc Consensus Group meeting. Cerebrovasc Dis 1996; 6: 315–24. 2. Alberts MJ, Lyden PD, Zivin