Summary: Acute Stroke Intervention

It is important that the type of stroke is diagnosed quickly to reduce the damage done to the brain and also to determine the right type of treatment because one treatment for one kind of stroke can be harmful to someone who has had a different kind. A number of different medications may be given at the hospital to help break up the clot and prevent the formation of new clots. For Ischemic stroke the treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, along with an injection of a tissue plasminogen activator (TPA). TPA works by dissolving clots but it needs to be injected within 4.5 hours of stroke symptoms once they have presented themselves. Hemorrhagic stroke treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.(http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/treatment/txc-20117296) Because strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke,

Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.

This paper presents the Appraisal of the Stroke Management Clinical Practice Guideline (CPG) in relations to the selected scenario according to the Midwifery discipline. Health Professionals would use the CPG in order to improve patient care which is supported by evidence and recommendations (Hoffman et al, 2013, p.326). In which the appraisal would be applied in real life scenarios within the professional settings in order to investigate the best practice guideline. This is done by analysing the CPG according to the AGREE 11 tool. The AGREE 11 instrument is to assess the CPG, provide strategies in order to develop the guidelines and also inform the strengths and weakness of

Stroke is the third most devastating problem in the world of which, Ischemic cerebral stroke is the commonest cause of death and disability [1]. One of the leading causes for cerebral ischemia is due to thrombosis or embolus formation in the cerebral artery that leads to inadequate supply of blood [2]. At present, the only well-established treatment strategy for stroke is to dissolve the thrombus or embolus by using recombinant tissue plasminogen activator (t-PA) [3], but it has low therapeutic index with complications like hemorrhage. However, the rapid reperfusion itself is exuberating the neuronal injury by promoting the generation of oxygen free radical and also stimulating the inflammatory response. So, both ischemia and reperfusion were associated with wide range of pathological changes like glutamate mediated excitotoxicity, inflammation, calcium overload, oxidative stress, apoptosis and blood brain barrier dysfunction

According to Sandre and Newbold (2016), telemedicine is defined as the use of information technology to provide long distance health services; this can lead to accessibility to healthcare resources to vulnerable populations, such as individuals in a rural community, in which distance causes limitation in available healthcare services. One of the aspects of telemedicine that I am interested in is telestroke, which is the use of computer technology for long distance consultation, in which a neurologist from off site, is able to sign in to a hospital network, and through video technology, perform an assessment on possible stroke patients. Worldwide, stroke is the third leading cause of death and therefore, implementation of technology to diagnose

Aside from interventions, there are mediciation to help treat stroke. For ischemic stroke, it is important to restore blood flow to the brain. Aspirin or antihypertension will

An ischaemic stroke occurs due to the restriction of blood supply to an area of the brain, thus initiating a process called the ischaemic cascade (Deb, Sharma & Hassan, 2010). This begins with the depletion of local oxygen stores, causing disruptions in the production of energy compounds such as adenosine triphosphate (ATP). The depletion in energy may cause tissue death (infarction), where occlusion for 5-10 minutes may lead to irreversible brain dysfunction (Karaszewski et al., 2009). Inadequate energy supplies leads to a malfunction of cells ability to perform action potentials, also resulting in the swelling of neuron and glial cells (). Cells at the core of the ischaemia will die of necrosis (premature cell death), where apoptosis (programmed

Stroke ranks high as a cause of adult long term disability in the world1 and interferes with patients’ quality of life2. Patients with stroke are unable to carry out their activities of daily living3. Despite extensive rehabilitation, the affected upper extremity is severely impaired in more than half individuals with stroke. The loss of input from the corticospinal system after stroke reduces the ability to selectively activate sets of muscles needed to perform skilled motor task. The recovery process after an episode of stroke has been shown to include the formation of new synaptic connections in undamaged cortical areas and the use of residual descending pathways. During the process of cortical reorganization new neural connections may affect

Sorry to hear about your grandmother. Hope all is well. As of now ,no one in my family experienced a stroke and hoping it stays that way. Strokes or any disease can happen to any one. We are future nurses and will be dealing with strokes and much more. Being a nurse comes from the heart and is strived with compassion, love, and integrity.

Annually 780000 people in the USA suffer a new or repeated stroke, which transforms to one stroke attack every 40 (Elissa, Krass & Bajorek,2012 ). Intravenous tissue plasminogen activator (tPA) is the only evidence-based treatment for acute ischaemic stroke. However, the use is limited. There were certain barriers identified for low utilization of tPA, and they were broadly classified as “Pre- admission” and “Post-admission” barriers. Pre-admission barriers include decisions made in patient care by patient or paramedics before bringing the patient to the hospital. Late arrival to the hospital is a major factor to narrow the administration of tPA due to the limited time window. In Australia, 61% of patients are ineligible to receive tPA due to late arrival to hospital (Elissa, Krass & Bajorek,2012). Post-admission barriers include the delay in evaluation and treatment, shortage of facilities and indecision to consider risks vs. benefits of tPA. According to Elissa, Krass & Bajorek (2012) the most important random controlled trials are ECASSIII and NINDS( National Institute of Neurological Disorders and Stroke) that give evidence on the usage of IV tPA. Research indicates that, with tPA administration, there is a decrease in disability at 90days from a stroke. Efforts are needed to focus the barriers on using and encouraging applicable execution of the stroke treatment guidelines to enhance the

The abstract provided includes descriptive statistics as it is describing the population of patients in stroke rehabilitation and their incidence, characteristics and consequence of falls. After reading the abstract, there is information that I feel is missing in order to implement effective change. The abstract stated that extrinsic and intrinsic factors impacted a portion of the falls, as well as 31% of falls being unclassified. Because of the shortage of details, I would like to know more about the falls including:

Time is important in the care of acute stroke patients, so improving time for thrombolysis will improve outcomes for patients with stroke. We have tried to improve efficiency of the acute stroke care by using IT (Information and Communications Technology). We aim to achieve the median DTN (Door-to-Needle) time of 30 minutes. In this paper, we explain the design of a protocol system “t-PA Scramble” that improve the efficiency by perspective, lean and concurrency, and technical solutions of an information system “Task Calc. Stroke” that is implemented to fulfill the role of communication, navigation and aggregation, describe the performance, and discuss our future

Computed Tomography perfusion imaging is used as a primary method for evaluating patients detected with an acute stroke. Computed Tomography perfusion imaging provide information about the presence and site of vascular occlusion, the presence and extent of ischemia, and about the tissue viability. This data may help the doctor to determine and confirm the case of thrombolysis

A stroke is a medical emergency. Time is critical factor to treat ischemic stroke which is the blockage of main artery by blood clots. In this situation, a CAT scan revealed that the patient came in with ischemic stroke. Due to urgency of treatment in emergency room, TPA (tissue plasminogen antigen medication can be administered with two doctor’s signatures, (Monti, 2015). The patient went to respiratory failure and was then put on mechanical ventilator as per protocol of emergency treatment. Then, he was transferred to ICU for further treatment. Deontological theories of ethics stated that “moral rules are absolute and apply to all people, for all times, in all situations” (Burkhardt, 2014, p. 46). In this specific scenario, Kant’s deontological theory applied to curing the patient.

The over the counter medication once known only for its ability of easing aches and pains or fighting off fever and inflammation is proving itself to be quite the miracle drug. Aspirin has become part of the protocol for stroke victims as a preventative measure due to its neuro-protective benefits. Stroke can cause lesions in cerebral white matter, which may result in cognitive impairments such as deficits in learning and memory. White matter lesions (WML) have also been linked to increasing the risk of post-stroke dementia. Cerebral white matter damage has been widely overlooked. Comprised of oligodendrocytes that form the insulating myelin in the CNS, white matter is evidentially just as vulnerable to ischemia as gray matter.