ABSTRACT
BACKGROUND: Thrombolysis with recombinant tissue plasminogen activator (rt-PA) and interventional thrombectomy are evidence-based causative therapies in acute stroke; however, the clinical benefit for the patient has been proven to be highly time-dependent. METHODS: A review of critical time intervals in acute stroke management and possibilities for modification is presented. RESULTS: Both prehospital and in-hospital times can be reduced with proven clinical benefits. The means to achieve time reductions are diverse and require clear workflow guidelines and continuous training. CONCLUSION: Optimization of time management during the complete acute diagnostics and treatment procedure by avoiding specific delays and streamlining universal workflow is of utmost importance regarding the efficiency and safety of treatment.
Subject(s)
Brain Ischemia , Brain/physiopathology , Stroke , Tissue Plasminogen Activator/drug effects , Fibrinolytic Agents , Humans , Thrombolytic Therapy , Time Management , Treatment OutcomeABSTRACT
INTRODUCTION: Acute capsular injuries of the elbow joint and its ligaments predominantly occur after joint dislocation or subluxation. Together with lateral and medial epicondylitis they represent a common injury pattern in radiology, orthopedic and trauma surgery. CLINICAL ISSUE: Because of the complexity of the elbow joint, knowledge of the elbow dislocation and injury pattern as well as the anatomy is essential in order to adequately estimate the injury severity and joint stability. This is crucial for the correct diagnosis and choice of treatment. Systematic physical examination and careful radiographic evaluation are components of an adequate management of acute soft tissue elbow injuries. DIAGNOSTIC WORK-UP: The cost-effective ultrasound has emerged as a useful imaging modality for the diagnosis of acute joint and soft tissue pathologies especially in the acute phase after injury. Ultrasound as a diagnostic tool enables visualization of motion sequences during dynamic examination and therefore a better understanding of pathologies. Ultrasound examinations of the most common injuries of the elbow joint are presented in this overview.