Ka hoʻohālikelike ʻana o nā unahi prehospital no ka wānana ʻana i ka hoʻopiʻi ʻana o ka moku mua i ka hoʻonohonoho ʻana o ka Ambulance.
ʻO nā unahi prehospital a me ko lākou pono i nā ambulances, kahi noiʻi i paʻi ʻia ma Jama e hoʻomaka me kēia nīnau: he aha nā hana a me nā helu kūpono o nā unahi wānana no ka occlusion moku mua i ka wā i hōʻoia ʻia i waho a hoʻohālikelike i ke poʻo i ke poʻo i ka hoʻonohonoho lawelawe olakino?
Ma kēia noiʻi ʻana o nā maʻi i loaʻa i nā code stroke acute, 7 prehospital prediction scales i kālailai ʻia
Ma kēia noiʻi pūʻulu o nā maʻi 2007 i loaʻa i nā code stroke acute stroke, ua hōʻike ʻo 7 mau unahi wānana i nā helu pololei maikaʻi, kikoʻī kiʻekiʻe, a me ka haʻahaʻa haʻahaʻa, makemake nui i ka Los Angeles Motor Scale a me ka Rapid Arterial Occlusion Evaluation scale.
Ua makemake nui nā kumukūʻai kūpono i ka pālākiō Prehospital Acute Stroke Severity.
Hōʻike nā hualoaʻa i kēia manawa he ʻano koʻikoʻi nā ʻokoʻa liʻiliʻi akā koʻikoʻi i ka helu ʻana i ka pololei i nā heluna nui no ka hōʻemi ʻana i ka lohi o ka mālama ʻana, me ka hoʻomaikaʻi hou ʻana i nā hopena lapaʻau, a pono e noʻonoʻo ʻia kēlā kūpono ma mua o ka hoʻokō ʻana i kahi pālākiō.
HUAKAI, E kipa aku i ka ʻūlū ZOLL MA EMERGENCY EXPO
ʻO ke koʻikoʻi o nā unahi pre-hospital i nā ambulances
ʻO ka maikaʻi o ka endovascular thrombectomy (EVT) no ka hōʻailona nui o ka moku mua (sLAVO) e emi nui me ka manawa.
No ka mea, ua kaupalena ʻia ʻo EVT i nā kikowaena stroke ākea, prehospital ke hele ʻO ka poʻe maʻi me nā code stroke acute no sLAVO he mea koʻikoʻi, a ʻoiai ke hoʻohana ʻia nei kekahi mau unahi wānana, ʻaʻole i lawa ka hōʻoia waho, ka hoʻohālikelike poʻo a me ke poʻo, a me ka ʻikepili kūpono.
Pahuhopu: E alakaʻi i ka hōʻoia waho a me ke poʻo-i-poʻo hoʻohālikelike o 7 sLAVO wānana wānana i ka hoʻonohonoho ʻana i ka lawelawe olakino kūikawā (EMS) a e loiloi i ka hiki ke kūpono e ka EMS paramedics.
Ua mālama ʻia kēia noiʻi cohort ma waena o Iulai 2018 a me ʻOkakopa 2019 ma kahi kikowaena kūlanakauhale nui ma Netherlands me ka heluna kanaka ma kahi o 2 miliona mau kānaka a ua komo pū me 2 EMS, 3 mau kikowaena stroke ākea, a me 4 mau kikowaena stroke mua.
ʻO nā poʻe i komo he mau maʻi maʻi maʻi ʻo 18 mau makahiki a ʻoi paha i hoʻāla ʻia kahi code stroke acute stroke i hoʻomaka ʻia e EMS.
No ka 2812 acute stroke codes, 805 (28.6%) i kāpae ʻia, no ka mea, ʻaʻohe noi i hoʻohana ʻia a ʻaʻole i loaʻa nā ʻikepili lapaʻau, waiho ʻia nā maʻi 2007 i hoʻokomo ʻia i nā loiloi.
Ua kālailai ʻia nā unahi wānana prehospital
ʻO nā noi me nā mākaʻikaʻi lapaʻau i hoʻopiha ʻia e ka EMS paramedics no kēlā me kēia code stroke acute stroke e hiki ai ke kūkulu hou ʻana i nā unahi wānana 7: Los Angeles Motor Scale (LAMS); ʻO ka loiloi wikiwiki o ke kīʻaha (RACE); Mea Hana Hoʻoholo Hoʻoholo ʻo Cincinnati Stroke Triage; Prehospital Acute Stroke Severity (PASS); maka-maka-lima-manawa-olelo; ʻO ka hoʻāʻo ʻana o ka hoʻāʻo ʻana i ka hoʻāʻo ʻana i ka pā no ka hoʻokele pilikia; a me ka nana, ka asymmetry o ka helehelena, ka pae o ka ike, ka pau ana/ka noonoo ole.
ʻO nā hopena mua a me ke kula kiʻekiʻe i hoʻolālā ʻia ʻo sLAVO a me nā helu kūpono (ʻo ia ka hapa o nā code stroke acute i hiki ke kūkulu hou ʻia ka pākaukau prehospital).
Hoʻokomo ʻia nā ana hana wānana i ka pololei, ka ʻike, ka kikoʻī, ka ʻōlelo kuhikuhi Youden, a me nā waiwai wānana.
ʻO nā maʻi 2007 i loaʻa i nā code stroke acute (mean [SD] makahiki, 71.1 [14.9] makahiki; 1021 [50.9%] kāne), 158 (7.9%) i sLAVO.
Mai ka 0.79 a hiki i ka 0.89 ka pololei o nā unahi, me ka loaʻa ʻana o nā helu kiʻekiʻe loa o LAMS a me RACE.
ʻO ka naʻau o nā unahi mai 38% a 62%, a me ka kikoʻī mai 80% a 93%.
Mai ka 78% a hiki i ka 88%, me ka helu kiʻekiʻe loa no ka pālākiō PASS.
Ua ʻike ʻia kēia haʻawina ʻo nā unahi wānana 7 a pau he pololei maikaʻi, kikoʻī kiʻekiʻe, a me ka naʻau haʻahaʻa, ʻo LAMS a me RACE nā unahi helu kiʻekiʻe loa.
ʻO nā kumukūʻai kūpono ma waena o 78% a me 88% a pono e noʻonoʻo ʻia ma mua o ka hoʻokō ʻana i kahi pālākiō.
jamaneurology_nguyen_2020_oi_200086_1612851442.47901E heluhelu pū nō hoʻi:
ʻO ka hōʻoia ʻana o ka mālama ʻana i ka Stroke no ka Halemai Hoʻomanaʻo o Freemont
Ke kiʻekiʻe pilikia no ka ʻehaʻeha no nā kahu hānai me nā maʻi noʻonoʻo
He pilikia ka ma'i ma'i no ka po'e me nā hola hana lō'ihi
ʻO ka Scale Stroke Prehospital Cincinnati. ʻO kāna hana ma ka 'Oihana Kūloko