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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
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Reducing care time after implementing protocols for acute ischemic stroke: a systematic review.

Karina Fonseca de Souza Leite1, Samuel Ribeiro Dos Santos1, Rubia Laine de Paula Andrade1

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Implementing acute ischemic stroke protocols improves in-hospital care times. However, faster symptom recognition in prehospital settings is crucial for better outcomes in acute ischemic stroke patients.

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Health Services Research

Background:

  • Acute ischemic stroke treatment necessitates rapid intervention and symptom recognition.
  • Cerebral reperfusion therapy is a critical component of acute ischemic stroke management.
  • Timely care significantly impacts patient outcomes in stroke cases.

Purpose of the Study:

  • To evaluate the effectiveness of acute ischemic stroke protocols in reducing patient care times.
  • To analyze the impact of implementing standardized protocols on stroke treatment efficiency.
  • To identify key time intervals affected by stroke protocol implementation.

Main Methods:

  • Systematic review of primary studies published between 2011 and 2020.
  • Inclusion of studies in Portuguese, English, and Spanish focusing on acute ischemic stroke.
  • Data extraction and narrative synthesis by independent reviewers, with methodological quality assessment.

Main Results:

  • Thirty-five studies were included out of 11,226 initial publications.
  • Protocol implementation showed effectiveness in improving door-to-image, image-to-needle, and door-to-needle times.
  • Limited improvement was noted in symptom-onset-to-door time; study population clarity was a limitation.

Conclusions:

  • Protocol implementation has led to significant advances in in-hospital stroke care.
  • Enhanced prehospital care and earlier symptom recognition are essential for optimizing stroke treatment.
  • Further research is needed to address limitations in defining the study population for stroke protocol effectiveness.