Management of Ischemic Stroke: Part 1. Emergency Room Management
REVIEW-NARRATIVE
Management of Ischemic Stroke: Part 1. Emergency Room
Management
Christine Lu-Emerson, MD
1
David Likosky, MD
2,3
Alpesh Amin, MD, MBA, FACP
4
David Tirschwell, MD, MSc
1,5
1 Department of Neurology, School of Medicine, University of Washington, Seattle, Washington.
2 Stroke Center, Evergreen Hospital Medical Center, Seattle, Washington.
3 Clinical Faculty, School of Medicine, University of Washington, Seattle, Washington.
4 Department of Medicine, Hospitalist Program, University of California, Irvine, California.
5University of Washington (UW) Medicine Stroke Center, Harborview Medical Center, Seattle, Washington.
Disclosure: Nothing to report.
BACKGROUND: Acute ischemic stroke is commonly encountered by the hospitalist. There have been dramatic changes in our ability to care for these patients acutely. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) primary stroke center certification has become progressively more important to institutions nationally and includes many aspects of initial evaluation and treatment.
PURPOSE: Acute treatment involves the rapid assimilation of patient characteristics, laboratory results, and imaging results.
There are a growing number of potential acute therapies with a range of risk, benefit, necessary time windows, and specific eligibility criteria.
DATA SOURCES: Primary trials, current guidelines.
CONCLUSIONS: The hospitalist is well-positioned to play a major role in the treatment of stroke patients as well as the systems work that aids in the management of this population. Journal of Hospital Medicine 2010;5:33–40. VC 2010 Society of
Hospital Medicine.
KEYWORDS: cerebrovascular disorders, emergency room, guidelines, stroke.
Additional Supporting Information may be found in the online version of this article.
The term ‘‘stroke’’ is defined by the World Health Organization as ‘‘rapidly developed clinical signs of focal (or global) disturbance of cerebral
Management of Ischemic Stroke: Part 1. Emergency Room
Management
Christine Lu-Emerson, MD
1
David Likosky, MD
2,3
Alpesh Amin, MD, MBA, FACP
4
David Tirschwell, MD, MSc
1,5
1 Department of Neurology, School of Medicine, University of Washington, Seattle, Washington.
2 Stroke Center, Evergreen Hospital Medical Center, Seattle, Washington.
3 Clinical Faculty, School of Medicine, University of Washington, Seattle, Washington.
4 Department of Medicine, Hospitalist Program, University of California, Irvine, California.
5University of Washington (UW) Medicine Stroke Center, Harborview Medical Center, Seattle, Washington.
Disclosure: Nothing to report.
BACKGROUND: Acute ischemic stroke is commonly encountered by the hospitalist. There have been dramatic changes in our ability to care for these patients acutely. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) primary stroke center certification has become progressively more important to institutions nationally and includes many aspects of initial evaluation and treatment.
PURPOSE: Acute treatment involves the rapid assimilation of patient characteristics, laboratory results, and imaging results.
There are a growing number of potential acute therapies with a range of risk, benefit, necessary time windows, and specific eligibility criteria.
DATA SOURCES: Primary trials, current guidelines.
CONCLUSIONS: The hospitalist is well-positioned to play a major role in the treatment of stroke patients as well as the systems work that aids in the management of this population. Journal of Hospital Medicine 2010;5:33–40. VC 2010 Society of
Hospital Medicine.
KEYWORDS: cerebrovascular disorders, emergency room, guidelines, stroke.
Additional Supporting Information may be found in the online version of this article.
The term ‘‘stroke’’ is defined by the World Health Organization as ‘‘rapidly developed clinical signs of focal (or global) disturbance of cerebral
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