ABC: časopis urgentne medicine (Jan 2016)
Stroke: From call to hospital how much time we need
Abstract
INTRODUCTION: Stroke represents medical emergency In developed countries it is the third leading cause of death. Intravenous thrombolytic therapy with recombined tissue plasminogen activator (rtPA) represents an efficient way of treatment and requires a rapid response, i.e. the existence of a good organization on all levels, including the pre hospital one. The main goal is that the organization of emergency medical service is such that it can reduce the time between the stroke onset and the application of thrombolytic therapy to a minimum. AIM: The objective of the research conducted at Emergency Medical Service, Belgrade was to show the duration between the beginning of the call placed to 194 to hospitalization of patients with suspected stroke. MATERIALS AND METHODS: Prospective research was conducted in the period from 01.10.2014. to 30.11.2014. in which all patients with a diagnosis of suspected stroke and Transient Ischemic Attack (TIA) were included. Duration of the conversation at the reception of call, activation time (from acceptance of the call on 194 to delivery to the team), reaction time (arrival on scene) and duration of intervention were monilorcil. RESULTS: From 473 analyzed medical reports 37 (7,8%) were accepted as priority 1 calls, and 436 (92,2%) as priority 2 calls. Average activation time was 11.15±13.82minutes (Med=5.10, IKO (1.86; 16.38)),significantly shorter activation time was noticed with calls which were accepted as the first order of priority (p<0,001). From the beginning of the conversation on 194 to patient's admission to the hospital, an average time was 58.64±20.10 minutes(Med=56.15,IKO (44.38; 69.28)). CONCLUSION: 422 (95.3%) patients reached the hospital in a period shorter than 98 minutes from the call to 194. Although the time of arrival of patients with stroke to appropriate health care institution leaves enough time to conduct appropriate diagnostics and apply suitable therapy, there is a need to work on further improvement.