AAN 2011

ACUTE STROKE: BASIC CONCEPTS OF THROMBOLYTIC THERAPY AND HYPERTENSION MANAGEMENET BY DOCTORS IN THE PREHOSPITAL SETTING.

Persi Gabriel Gustavo, Antongiovanni Sabrina, Parisi Virginia Laura, Visconti Daniela, Campuzano Miguel Angel, Martín María Clara, Gatto Emilia Mabel.

Sanatorio de la Trinidad Mitre, CABA, Argentina

Background and purposes: In acute ischemic stroke, accurate management is essential to reduce damage so the rapid recognition of symptoms and a quick arrive to a Hospital  Emergency Room are mandatory due to the narrow window of time for thrombolytics therapy.
The aim of our study is to evaluate knowledge about acute ischemic stroke and hypertension (HTA) management by Emergency Care Unit Doctors (ECUD), and  stroke treatment suggested by Emergency Room Doctors (ERD).
Material and methods: ECUD and ERD were asked to complete a self administered anonymous questionnaire that contained items about acute stroke diagnosis and management and acute HTA treatment. Questionnaires were given to doctors at the emergency department.
Results: A total of 100 questionnaires were included for the analysis, 50 responded by ECUD and 50 by ERD. Sixty four percent of ECUD chose not to treat HTA at  home. Among those ECUD participants that selected to treat HTA, 43.18% indicated  Enalapril. Seventeen ECUD (34%) ignored about an especific acute stroke treatment, 13/50 chose rTPA but only 5 (16.13%) knew the correct therapeutic window.
Only 48% of ERD answered correctly for the maximun arterial tension values that required treatment in acute stroke. In this setting, a positive answer about knowledge for acute treatment for stroke  was obtained  in 46 (92%) of ERD. However , 60% of them  knew the therapeutic window and  26% chose the wrong treatment. Fourty eight doctors in the emergency room responded that an acute ischemic stroke requires admission but only 36 considered the same about transient ischemic attack.
Conclusions: This study shows there are  failures in  acute stroke management by ECUD and ERD. Therefore, we must target our efforts to improve their knowledge and training given that they are the first link between the patient 63rd Annual Meeting of the American Academy of Neurology