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1.
Acta Clin Belg ; 75(4): 267-274, 2020 Aug.
Article in English | MEDLINE | ID: mdl-31081471

ABSTRACT

INTRODUCTION: Stroke is a development of an acute focal neurological deficit with an ischemic or hemorrhagic origin. Thrombolysis within 4.5 h of ischemic stroke onset improves outcome. Guidelines recommend administration of intravenous recombinant tissue plasminogen activator within 60 min upon arrival at the hospital, meaning the door-to-needle time (DNT) should be less than 60 min. In this study, a stroke protocol was introduced at the emergency department of the Ghent University Hospital with a primary goal to shorten the DNT. METHODOLOGY: This study was an uncontrolled before-after cohort study. A 'Code Stroke' protocol (CSP) was implemented and the results from the pre-code stroke protocol period (Pre-CSP period, from 15 August 2016 until 5 March 2017) were compared with the results from the post-code stroke protocol period (Post-CSP period, from 6 March 2017 until 16 July 2017). RESULTS: The median DNT decreased significantly from 57 min in the Pre-CSP period to 33 min in the Post-CSP period (p < 0.001). The door-to-triage time (DTT), triage-to-emergency physician time (TET), emergency physician-to-CT time (ECT) and CT-to needle time (CNT) decreased significantly Post-CSP compared to Pre-CSP. When adjusting the results for other variables that might have an influence on these time intervals, the TET, ECT and CNT also decreased significantly. There was a statistically significant effect of the implementation of the CSP on the number of patients treated with a DNT within 20, 30, 45 and 60 min (p = 0.008). CONCLUSION: A significant decrease in DNT can be achieved with the implementation of this stroke protocol.


Subject(s)
Fibrinolytic Agents/therapeutic use , Ischemic Stroke/drug therapy , Thrombolytic Therapy/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Tissue Plasminogen Activator/therapeutic use , Administration, Intravenous , Aged , Aged, 80 and over , Computed Tomography Angiography , Emergency Medicine , Emergency Nursing , Emergency Service, Hospital/organization & administration , Feasibility Studies , Female , Humans , Ischemic Stroke/diagnostic imaging , Male , Middle Aged , Neurologists , Patient Care Team/organization & administration , Perfusion Imaging , Radiologists , Tomography, X-Ray Computed , Triage/organization & administration
2.
Acta Clin Belg ; 72(5): 361-364, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28251862

ABSTRACT

In the literature, possible systemic effects on health of inhalation or ingestion of white spirit are well described. Only a few case reports discuss the toxic skin effects that can occur following massive ingestion. Ingestion of large amounts of white spirit produces a watery diarrhoea with a high concentration of white spirit, resulting in perineal skin burns when there is prolonged contact. We describe a patient who developed partial thickness perineal skin burns after ingestion of white spirit and review the literature. The present data indicate that conservative therapy of the skin burns is recommended.


Subject(s)
Burns, Chemical/etiology , Diarrhea/chemically induced , Hydrocarbons/adverse effects , Suicide, Attempted , Diarrhea/complications , Humans , Male , Middle Aged , Perineum
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