Bringing door-to-needle times within the European benchmarks results in better stroke patients outcomes in a spoke hospital from the Apulian Region

Global Awareness and Response to Early Symptoms of Acute Stroke: A Systematic Literature Review

Stroke is a condition that leaves persistent disability and causes high mortality worldwide. Knowledge of recognizing early symptoms along with awareness of immediate response to acute stroke among the general population has proven insufficient. Pre-attendance delays adversely affect the time window from symptoms onset to needle time, therefore the effect of recanalization treatments. Although 35% of patients are potentially eligible for these treatments such as intravenous thrombolysis only about about 8-10% of them manage to receive. The study aimed to investigate the association between knowledge of early symptoms in the general population and proper response to acute stroke through prompt activation of emergency medical services (EMS) independently of sociodemographic factors. A systematic review was conducted to identify relevant studies that assessed the general population's knowledge of early symptom recognition and awareness of immediate response to acute stroke. Two investigators reviewed articles published in the PubMed database, from December 1, 2023, to February 29, 2024. The search yielded a total of 340 articles. After the 340 articles were screened, 293 reports were excluded due to title and abstract, irrelevant studies, or when the full text was not available. Finally, a total of 10 articles were included in this systematic review. Out of ten studies included in this review, seven studies were conducted in Asia, in one study the origin continent is Oceania, while the remaining two studies come from America. All studies were designed and conducted as cross-sectional studies. The most commonly recognizable early symptoms of a stroke were found to be difficulty in speaking or understanding speech, weakness on one side of the body including the face, plus sudden dizziness. Regarding responding to early stroke symptoms, the EMS call option gathered the most preferences of the respondents by 80%. Enlightenment campaigns are needed to highlight acute stroke symptoms unknown to the general public such as facial asymmetry.

Nursing and Institutional Responsibilities for In-Hospital Stroke

In-hospital stroke events occur less often than stroke outside of a health care facility; yet, the need for timely evaluation and treatment is the same regardless of geographic location. During hospitalization, nurses are generally the first to recognize possible symptoms of stroke and activate emergency protocols. Such actions in response to changes in patient condition are critical to optimal patient outcomes. A recent scientific statement from the American Heart Association notes that patients with in-hospital stroke are likely to experience delayed recognition of symptoms, less likely to receive intravenous thrombolysis therapy, and have worse outcomes compared with community-occurring stroke. The aim of this article is to expand upon that scientific statement to assist nurses and acute care hospitals in the United States and elsewhere with similar health care systems to create evidence-based, nurse-driven protocols for in-hospital stroke recognition and management.