Curitiba acute ischemic stroke protocol: a university hospital and EMS initiative in a large Brazilian city / Protocolo de AVCi agudo em Curitiba: uma iniciativa de um hospital universitário e do SAMU
Arq. neuropsiquiatr
; 69(3): 441-445, June 2011. ilus, tab
Article
in En
| LILACS
| ID: lil-592499
Responsible library:
BR1.1
ABSTRACT
Few healthcare centers in Brazil perform thrombolytic therapy for acute ischemic stroke (AIS) patients. OBJECTIVE:
The aim of this study was to describe an interinstitutional protocol for the rapid identification and thrombolytic treatment of AIS patients at a public health hospital in a large Brazilian city.METHOD:
Emergency medical services (EMS) personnel evaluated 433 patients with possible stroke during a six-month period. After a standard checklist, patients with suspected AIS and symptoms onset of less than two hours were evaluated at our University Hospital (UH).RESULTS:
Sixty-five (15 percent) patients met the checklist criteria and had a symptom onset of less than two hours, but only 50 (11 percent) patients were evaluated at the UH. Among them, 35 (70 percent) patients had ischemic stroke, 10 (20 percent) had hemorrhagic stroke, and 5 (10 percent) had other diagnoses. Of the 35 ischemic stroke patients, 15 (43 percent) underwent IV thrombolysis.CONCLUSION:
The present study demonstrated that trained EMS workers could help to improve the rate of thrombolytic treatment in large Brazilian cities. Permanent training programs for EMS and hospital staff, with quality control and correct identification of AIS patients, should be implemented to increase appropriate thrombolytic therapy rates in Brazil.RESUMO
No Brasil, apenas alguns hospitais realizam terapia trombolítica para o acidente vascular cerebral isquêmico agudo (AVCiA). OBJETIVO:
O objetivo deste estudo foi descrever um protocolo inter-institucional para a rápida identificação e para o tratamento trombolítico de pacientes com AVCiA em hospital público de Curitiba, PR.MÉTODO:
O Serviço de Atendimento Médico de Urgência (SAMU) avaliou 433 pacientes com possível AVC durante um período de seis meses. Depois de um check list padrão, os pacientes com suspeita de AVCiA e início dos sintomas inferior a duas horas, foram avaliados no Hospital de Clínicas (HC).RESULTADOS:
Sessenta e cinco (15 por cento) pacientes preencheram os critérios propostos, porém apenas 50 pacientes (11 por cento) foram avaliados no HC. Destes, 35 (70 por cento) eram AVC isquêmico (AVCi), 10 (20 por cento) eram hemorrágicos e 5 (10 por cento) tiveram outros diagnósticos. Dos 35 pacientes com AVCi, 15 (43 por cento) foram submetidos a trombólise IV.CONCLUSÃO:
O presente estudo demonstrou que o treinamento do SAMU poderia auxiliar na otimização da terapia trombolítica em grandes cidades brasileiras. Programas permanentes de treinamento com controle de qualidade, caracterizados pela correta identificação de pacientes com AVCiA devem ser realizados nos hospitais em parceria com o SAMU para elevar as taxas de tratamento trombolítico no Brasil.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Thrombolytic Therapy
/
Tissue Plasminogen Activator
/
Stroke
/
Fibrinolytic Agents
Type of study:
Guideline
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Arq. neuropsiquiatr
Journal subject:
NEUROLOGIA
/
PSIQUIATRIA
Year:
2011
Document type:
Article
Affiliation country:
Brazil