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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Adherence to practice guidelines for transient ischemic attacks in an emergency department.
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Adherence to practice guidelines for transient ischemic attacks in an emergency department.

机译：遵守急诊科短暂性脑缺血发作的操作准则。

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摘要

OBJECTIVE: To evaluate the investigation and treatment of patients with a diagnosis of transient ischemic attacks (TIA) in the emergency department (ED) a tertiary care teaching hospital with a neuroscience referral program. METHODS: A chart review was conducted in the hospital. Consecutive ED charts with a diagnosis of TIA were included; each was reviewed by independent coders using a standardized data form. RESULTS: Two hundred and ninety-three TIA charts were reviewed; the gender ratio was 1:1 with a mean age of 66 years. Most patients (75%; 95% CI: 70, 80) were evaluated by ED physicians; the remaining patients were seen directly by referral services. The median time from symptom onset to ED arrival was 29 hours and the duration of symptoms was 4.6 hours. Most patients received CT scans (81%; 95% CI: 73, 85), complete blood counts (74%; 95% CI: 68, 79), and electrocardiograms (75%; 95% CI: 70, 80) in the ED. In 16% (95% CI: 13, 22) a carotid doppler was performed and in 26% (95% CI: 21, 31) an outpatient doppler was booked. Among those who were discharged (75%; 95% CI: 70, 80), antithrombotic medications were not prescribed to 28% (95% CI: 22, 34). CONCLUSION: Practice variation exists with respect to the investigation and treatment of TIAs in this tertiary-care teaching hospital. Carotid doppler investigation and use of anti-platelet therapy for patients with TIA are suboptimal. Clinical practice guidelines and rapid assessment TIA clinics may change these results.
机译：目的：评估在急诊科（ED）的急诊科（具有神经科学转诊计划）的诊断为短暂性脑缺血发作（TIA）的患者的调查和治疗。方法：在医院进行图表审查。连续的ED图可诊断为TIA。每个人都由独立的编码人员使用标准化数据表格进行审核。结果：回顾了293张TIA图;性别比为1：1，平均年龄为66岁。多数患者（75％; 95％CI：70、80）由ED医师评估;其余的患者可以通过转诊直接看到。从症状发作到ED到达的中位时间为29小时，症状持续时间为4.6小时。大多数患者接受了CT扫描（81％; 95％CI：73，85），全血细胞计数（74％; 95％CI：68，79）和心电图（75％; 95％CI：70，80）。 ED。进行了16％（95％CI：13、22）的颈动脉多普勒检查，而在26％（95％CI：21，31）中进行了门诊多普勒检查。在出院者中（75％; 95％CI：70、80），未开具抗栓药物的比例为28％（95％CI：22、34）。结论：该三级教学医院在TIA的调查和治疗方面存在实践差异。对于TIA患者，颈动脉多普勒检查和抗血小板治疗的使用效果欠佳。临床实践指南和快速评估TIA诊所可能会改变这些结果。

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