استفاده از پروتکل سکته مغزی حاد مربوط به امراض کودکان
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استفاده از پروتکل سکته مغزی حاد مربوط به امراض کودکان

عنوان فارسی مقاله: پیاده سازی و استفاده از پروتکل سکته مغزی حاد مربوط به امراض کودکان در طی 7 سال
عنوان انگلیسی مقاله: Pediatric Acute Stroke Protocol Implementation and Utilization Over 7 Years
مجله/کنفرانس: مجله امراض کودکان - The Journal Of Pediatrics
رشته های تحصیلی مرتبط: پزشکی
گرایش های تحصیلی مرتبط: مغز و اعصاب، پزشکی کودکان، قلب و عروق
کلمات کلیدی فارسی: سكته مغزي مربوط به امراض كودكان، سكته مغزي ايسكميك، خونريزي
کلمات کلیدی انگلیسی: pediatric stroke، ischemic stroke، hemorrhage
نوع نگارش مقاله: مقاله پژوهشی (Research Article)
نمایه: Scopus - Master Journals List - JCR - MedLine
شناسه دیجیتال (DOI): https://doi.org/10.1016/j.jpeds.2020.01.067
دانشگاه: Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
ناشر: الزویر - Elsevier
نوع ارائه مقاله: ژورنال
نوع مقاله: ISI
سال انتشار مقاله: 2020
ایمپکت فاکتور: 2/679 در سال 2019
شاخص H_index: 188 در سال 2020
شاخص SJR: 1/223 در سال 2019
شناسه ISSN: 0022-3476
شاخص Quartile (چارک): Q1 در سال 2019
فرمت مقاله انگلیسی: PDF
تعداد صفحات مقاله انگلیسی: 8
وضعیت ترجمه: ترجمه نشده است
قیمت مقاله انگلیسی: رایگان
آیا این مقاله بیس است: خیر
آیا این مقاله مدل مفهومی دارد: ندارد
آیا این مقاله پرسشنامه دارد: ندارد
آیا این مقاله متغیر دارد: ندارد
کد محصول: E14680
رفرنس: دارای رفرنس در داخل متن و انتهای مقاله
فهرست انگلیسی مطالب

Methods


Results


Discussion


References

نمونه متن انگلیسی مقاله

Discussion


Pediatric stroke protocol implementation at our center improved over the 7-year period. Protocol utilization by the ED and particularly by inpatient providers increased over time. Although the frequency of confirmed stroke or other neurologic emergency for which rapid neurologic evaluation was appropriate did not differ significantly over time (37% in period 1 and 39% in period 2), indicators of successful pediatric acute stroke protocol implementation, including the use and documentation of the PedNIHSS to assess stroke severity, increased. MRI as first neuroimaging study for most children with stroke-like symptoms also increased over time. MRI is the preferred first-line imaging in pediatric stroke, because CT is unable to differentiate common stroke mimics and has been reported to miss as many as 47%-84% of ischemic strokes in children that are later confirmed by MRI. Supportive care and IV fluids were provided to all children with acute stroke. In addition, the vast majority of children with ischemic stroke for whom secondary prevention with antithrombotic medication was indicated were started and discharged to home on these medications. Most published accounts of pediatric stroke protocol utilization have not provided an assessment of children with stroke with a delayed or missed diagnosis. Only 1 in 5 children for whom a pediatric stroke alert was activated had a final diagnosis of ischemic or hemorrhagic stroke. We searched carefully for children with delayed diagnosis of stroke, because the number of stroke mimics is significant. With radiology text searches, we were not able to identify any missed ischemic strokes. We did find 8 children (2%) for whom a pediatric stroke alert was not activated for >60 minutes after arrival to the hospital or after symptoms were noted for those already in the hospital. In these cases, pediatric neurology was frequently consulted, and the neurology team activated the stroke protocol after examining the child. It was difficult to discern retrospectively whether acute stroke was not recognized by the primary team or whether there was lack of familiarity with the pediatric stroke protocol and so a neurology consult was called instead of a stroke alert.Pediatric stroke protocol implementation at our center improved over the 7-year period. Protocol utilization by the ED and particularly by inpatient providers increased over time. Although the frequency of confirmed stroke or other neurologic emergency for which rapid neurologic evaluation was appropriate did not differ significantly over time (37% in period 1 and 39% in period 2), indicators of successful pediatric acute stroke protocol implementation, including the use and documentation of the PedNIHSS to assess stroke severity, increased. MRI as first neuroimaging study for most children with stroke-like symptoms also increased over time. MRI is the preferred first-line imaging in pediatric stroke, because CT is unable to differentiate common stroke mimics and has been reported to miss as many as 47%-84% of ischemic strokes in children that are later confirmed by MRI.13,14 Supportive care and IV fluids were provided to all children with acute stroke. In addition, the vast majority of children with ischemic stroke for whom secondary prevention with antithrombotic medication was indicated were started and discharged to home on these medications. Most published accounts of pediatric stroke protocol utilization have not provided an assessment of children with stroke with a delayed or missed diagnosis.5-7 Only 1 in 5 children for whom a pediatric stroke alert was activated had a final diagnosis of ischemic or hemorrhagic stroke. We searched carefully for children with delayed diagnosis of stroke, because the number of stroke mimics is significant. With radiology text searches, we were not able to identify any missed ischemic strokes. We did find 8 children (2%) for whom a pediatric stroke alert was not activated for >60 minutes after arrival to the hospital or after symptoms were noted for those already in the hospital. In these cases, pediatric neurology was frequently consulted, and the neurology team activated the stroke protocol after examining the child. It was difficult to discern retrospectively whether acute stroke was not recognized by the primary team or whether there was lack of familiarity with the pediatric stroke protocol and so a neurology consult was called instead of a stroke alert.

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