Gender Differences In Women

Strokes are caused by a block in the blood supply to the brain which causes a decrease in oxygen and delivery of other important supplies which facilitate proper functioning. Fifteen million cases are reported worldwide annually, although not all of these cases are mortalities, the large prevalence of strokes ranks it as the fourth leading cause of death in the United States. (Figueroa) Because of the time sensitivity associated with the lack of resources to the brain, strokes are considered a medical emergency and early recognition of symptoms can help decrease the amount of damage caused . Although strokes do not always cause death, strokes most often leave the individual with some physical and cognitive impairment.

The researchers attempt to minimize threats to external validity. The authors claims that the study has a structured management, and better coordination of care between the stroke multidisciplinary care team and the primary care team; significant improvements of median BI scores over a 12 month period was noted (z=−3.022, P = 0.003) (Aziz et al., 2013, p.5). This explains the prognosis of patients from moderately dependent on care givers to slightly dependent after one year. A multidisciplinary team comprise of stroke rehabilitation consultant, a family medicine consultant, two nurses (includes the stroke coordinator), and a Clinic aide are assigned for coordinating appointments and home visits, providing health education for stroke patients and family, and maintaining a registry of LTSC

The authors provide clear definitions of CSU and traditional stroke units (TSU), including acute (SU-A) versus rehabilitation-based care (SU-R). Importantly, the authors use the SUTC definition of CSU in this paper, as there is also emerging literature about comprehensive stroke centres which instead refer to a hyper-acute model of care involving facilities for acute intravenous or intra-arterial treatments, intensive monitoring, advanced imaging and neurosurgery.11

Medical experts emphasize that medical attention must be received within the first three hours of a stroke to repair blood flow and diminish damage.

A stroke is a form of brain attack, which is when blood and oxygen can’t get to a certain part of the brain causing cells to die. This causes permanent damage. Basically the longer you take to get to the hospital, the more damage there is.

According to Community Paramedic Taskforce Results 7/1/15-12/31/15 (2016), the average patient age was 71 years old, and 61% of these patients were female (n=247). This data is consistent with Rittner and Kirk’s study (1995) relating to age and gender distribution. In 2015 there were more people in this age group than in 1995, which increases reliance on EMS for services that do not always fall into the emergent category, yet do need intervention of some sort. To reduce burdening the EMS system with addressing non-emergent needs MIH/CP programs seek to connect the right patient, with the right care, at the right time. However, some of these patients are limited in mobility and cannot travel to a primary care provider to receive care.

This integrative review explores the difference of the onset-to-hospital arrival time between females and males with acute strokes. The results demonstrate that the means and medians of the hospital arrival times among female patients trend toward more delay than male patients, particularly in the Asian-Pacific and Middle Eastern region. However, the various evidences show that gender difference is not statistically significant.

Once you arrive at the emergency room, you experience more waiting depending on your current condition. Some of these waits depend on: length of stay, time waiting for assessment, condition, waiting for inpatient bed, and lack of resources. Finally, when you’re ready to leave the emergency department waits can occur, like waiting for an inpatient bed or a ride home (CIHI, 2012). All of these reasons impact the growing wait times, with older adults becoming more frequent in emergency departments and the increasing population of older adults these wait times are going to continue to grow causing more harm than good, if older adults are unable to receive the appropriate care in a timely matter (Cooke, Oliver, & Burns, 2012).

Adults and children are both affected by strokes. Strokes are one of the top ten causes of childhood death (Buzzard, 2013, pg. 9). Between 50 and 85 percent of children who have strokes will be affected with long-term health issues (Buzzard, 2013, pg. 9). These health issues may include learning difficulties, seizures and possible recurring strokes (Buzzard, 2013, pg. 9). Up to 20 percent of all strokes occur in people over the age of 55 years old (Buzzard, 2013, pg 7).(DeTallo, 2013)

Stroke is noted by Lee, Shafe and Cowie (2011) to be a major cause of both morbidity and mortality in the United Kingdom. It is estimated that close to 110,000 incidences of stroke occur in England annually (National Audit Office,2004) with recent studies reporting that the rate of incidence ranges between 1.36/1000 per year (Hippisley-Cox , Pringle , Ryan, 2004) and 1.62/100 per year between 2002 and 2004 (Rothwell et al,2004). Even though cases of deaths from stroke has decreased in the United Kingdom over the last forty years, stoke accounted to close to 46500 deaths in Wales and England in 2008 (accounted for 9 percent of all death cases (Lawlor et al,2002; Office for National Statistics,2008). The current United Kingdom health policy places a lot of emphasis on the reduction of stroke (Department of Health,2007,2008). Key to realizing this is the importance and need for better management of the vascular risk factors such as hypertension, high cholesterol, obesity, diabetes and atrial fibrillation. In this paper, we present an essay based on the assessment of care of an elderly patient suffering from six different pathologies with stroke (non-haemorrhagic) being our pathology of choice. A rationale for this choice is provided followed with the underlying pathophysiology of the chosen aspect of care and finally an evidenced based analysis of the nursing interventions required for the selected aspect of care.

The article emphasizes time as a critical aspect to acute ischemic stroke management. The leading method of treatment in AIS is intravenous rtPA because the door-to-needle time is less compared to the time it takes to do methods that use thrombectomy devices or catheterization. I believe that it is vital for people to know the signs and symptoms of acute ischemic stroke because it is one of the leading causes of death and disability. The faster one is able to identify these signs and symptoms, the better an outcome it would be for both the patient and their family members. The general public and hospital staff members should be educated on AIS. This article also briefly touches on the fact that patients suspected of having a more severe stroke (proximal artery occlusion) should be immediately transported to a

Hospital arrival time was calculated as the time from stroke symptom onset to arrival at the emergency department or the hospital. Forty percent of included articles defined stroke onset as the exact time that symptoms occurred and if patients have unclear stroke onsets or have symptoms after waking up, the time that they have last seen normal was used to be stroke onset. While, six articles have not distinctly described the onset whether stroke symptoms occurred during sleep (Barr et al., 2006; Centers for Disease Control and Prevention (CDC), 2007; Iosif, Papathanasiou, Staboulis, & Gouliamos, 2012; Knauft, Chhabra, & McCullough, 2010; Oh & Park, 2006; Yanagida, Fujimoto, Inoue, & Suzuki, 2014).

Overall, both of these prophets came from different backgrounds and lead similar lives and faced many challenges along the way. But, the one difference between these two prophets is that one was women. Nonthetha, had a much harder time spreading the word of God in southern Africa soly because she was a woman. However, most her earliest followers were women and then these women would begin to spread the word of God and then Men would start to join Nonthethas cause as well. She had faced a difficult climb to the top, but until the time of her death she had spread the word of God in the southern Africa. Harris did not face this challenge, the only challenge that he faced was that as he was spreading the word of God he was expelled from several

The article, “Few US stroke patients get blot-busting treatment”, written by Lisa Rapaport, discusses the probability of ischemic stroke patients to receive a specific treatment called thrombolysis. Thrombolysis is a type of therapy that helps dissolve blood clots, in this case, blood clots in the brain that causes stroke. According to the article, those who receive this treatment have fewer post-stroke problems. In order to receive this treatment and have it be successful, patients must arrive at a hospital with the proper tools to provide the therapy within four and a half hours of showing symptoms of stroke. Many patients, however, do not arrive at the hospital soon enough because they are unaware of the symptoms of stroke. On the other hand, some patients arrive to a hospital on time, but they are unable to receive thrombolysis because their hospital do not carry the right tools. Hospitals that do have the right tools are typically found where there is a higher proportion of college graduates. In a research study conducted from 2007 to 2010 by James Bruke, a neurologist, and his colleagues, they found that patients who received thrombolysis were about 78 years old, mostly white, and had other health issues such as heart problems or diabetes. Of the 844,241 people they studied, they found that only about four percent of them was actually able to undergo this treatment. The chances of patients obtaining thrombolysis depend on where they are geographically located. For

Dr. Bata’s study show there was a thirty minute advantage for patient who arrived via ambulance but only when the paramedics diagnosis and assigned which style of treatment would be provided to said patient (bata,2005). Our study is purposing an implementation of training and support for the paramedical staff and units within an area to allow everyone being transported to a medical center to have a short time frame from arriving at the hospital and receiving treatment. In many studies it has been pointed out that time is a crucial element when dealing with treatment for MI. “Those activating the prehospital medical response system without receiving prehospital random assignment experienced the longest delay from first medical contact to reperfusion, indicating a lost opportunity to enhance ST elevation myocardial infarction patient outcomes (bata,2005).” Out study is building on the foundation of a study performed by Iqbal Bata and team. MD Batas study was on time and medical contact with myocardial infarction. The study showed some revealing statistic on time delay for those who were transported to the hospital by ambulance or by personal delivery. The study was primary focus on the time differences between the different treatments over the actually treatment