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프로토콜을 활용한 신경학적 이상 증상 환자의 진단과 치료

Other Titles
 Diagnosis and Treatment of Patients With Acute Neurologic symptoms Using a Coordinated Response Protocol 
Authors
 성창민  ;  김의중  ;  윤유상  ;  정현수  ;  박인철  ;  허지회 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.17(5) : 424-430, 2006 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2006
Keywords
Medical Records ; Stroke ; Cerebral Infarction
Abstract
Purpose: Patient delays in seeking treatment of stroke and Emergency Department delays are major factors in preventing the use of thrombolytic therapy for stroke. For the achievement of rapid diagnosis and treatment in the emergency center, a unified and systematic confrontation of symptoms and good team cooperation are essential. Methods: Various departments involved in the management of acute stroke in the ED conferred to discuss ways to minimize door-to-CT and door-to-drug times in the ED. This team formulated the BEST (Brain salvage through Emergent Stroke Therapy) protocol to optimize the treatment of acute stroke patients. Our study employed the BEST protocol for four month during the period from October, 2004 to February, 2005. Inclusion criteria for the protocol were admission to our Hospital`s ED with an acute neurologic symptoms and an onset time of less than 12 hours. Results: Ninety-six patients, including fifty-eight men were enrolled in the study. Reasons for acute neurologic changes were ischemic stroke (66 patients), hemorrhagic stroke (22 patients), and metabolic causes (8 patients). Of the 66 ischemic stroke patients, 11 received tissue plasminogen activator (tPA) and 2 were administered Intra-arterial Urokinase (IAUK). Door-to-CT times before and after initiation of the BEST protocol were 47±19 minutes and 26±12 minutes, respectively (p-value=0.024). And door-to-drug times before and after the BEST protocol were 96±16 minutes and 67±28 minutes, respectively (p-value=0.035). Conclusion: Assembly of a specific "stroke team" and implementation of a well-designed protocol allows the most efficient evaluation and treatment of patients with acute stroke, thus minimizing both door-to-CT and door-to-drug times.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110001
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