Investigation About First Aid Of Stroke Patients In The Hospital

Objective:To investigate the "acute stroke emergency medical services "in the Second Affiliated Hospital of Kunming Medical University, the status of the emergency department for further optimization and improvement of emergency medical care of acute ischemic stroke efficiency and provide a theoretical basis.Method:The researchers involved in the Second Affiliated Hospital of Kunming Medical University, the work of the emergency department, patients arrive in emergency rescue or transfer immediately to a hospital for treatment of the five stages of the process broken down to form to record the way emergency medical services in acute stroke Process for the entire record, and in accordance with the《2010 China Guideline For Cerebrovascular Disease Prevention》.evaluation.Results:(1) Incidence among men compared to 57.89% in the proportion of women was 42.11%.69.17% of the patients in the event onset,90.98% of patients admitted from 120 first-aid station. (2) To establish intravenous access for all patients, all patients were monitored body temperature, pulse, respiration, heart rate, blood pressure and oxygen saturation,19.55% of the patients with unstable vital signs were carried out rescue,76.70% of patients with low oxygen saturation at 92%, were given oxygen treatment,78.95% of the patients treatment when clear consciousness, all patients had not used Glasgow Coma Scale (Glasgow Coma Scale) were scored. (3) All patients were asked whether the recent events (stroke, trauma, surgery, myocardial infarction and bleeding), past history (hypertension, diabetes, heart disease and drug allergies), and previous drug use.77.45% of the patients medical history information provided by the patients and their families together. All patients underwent neurological physical examination (no use of the U.S. National Institutes of Health Stroke Scale-NIH Stroke Scale, NIHSS for disease assessment). All patients underwent emergency head CT. (4) The emergency department diagnosis of 133 cases of "stroke" of those,130 cases were diagnosis 94 cases of ischemic stroke, hemorrhagic stroke in 36 cases,3 patients were misdiagnosed. (5) 94 cases of patients with acute ischemic stroke thrombolysis in 6 patients met the criteria, but did not use thrombolytic therapy,5 patients were family members do not agree with thrombolytic therapy,1 patient was not due to economic reasons thrombolysis; 88 cases do not meet the solution Suppository treatment standards, including 26 patients over treatment time window,18 patients age over 80 years of age, emergent head CT in 15 patients have significantly changed in acute cerebral infarction,9 patients systolic blood pressure> 180 mmHg or diastolic blood pressure> 100 mmHg,7 patients in the near future trauma, surgery, or bleeding,5 patients with stroke within 3 months recent history or history of myocardial infarction,4 patients platelet count less than 100×109 /L,3 patients had oral anticoagulation and INR>1.5.1 patients with blood glucose less than 2.7mmol/L. (6) 94 cases of ischemic stroke patients were treated with anti-platelet therapy,84 patients were given aspirin; 10 patients were considered not tolerate aspirin, clopidogrel given. All patients given aspirin dose of 100 mg/d. Associated with atrial fibrillation in 11 cases of ischemic stroke patients were given low molecular weight heparin.Conclusion:(1) Compared with the guidelines, the emergency physician immediately in all patients were vital signs were detected (temperature, pulse, respiration, heart rate, blood pressure and oxygen saturation) and the establishment of intravenous access, all patients received supplemental oxygen hypoxia Treatment of patients with unstable vital signs deal with immediate rescue. (2) Emergency physicians were collected for all patients with a history of data, but promote the use of a detailed assessment of Glasgow Coma Scale in patients with coma level. Emergency physicians of all patients underwent neurological examination, but promote the use of the U.S. National Institutes of Health Stroke Scale for thrombolytic therapy. The auxiliary examination of patients consumption over a long time, so we open the green channel, shorten the examination time.(3) 97.74% of emergency room physicians determine whether patients can clear the type of stroke and stroke, so that patients in the shortest period of time corresponding treatment. (4) 6 patients in this study were consistent with the standard thrombolytic therapy for various reasons are not used thrombolytic therapy. So should strengthen the propaganda and reassure the public concerns of fibrinolytic therapy. (5)84 patients were given aspirin dose aspirin in patients with ischemic stroke was 100 mg/d,should strictly follow the guidance provided dose.