Suyama Joe, Crocco Todd
University of Cincinnati, Department of Emergency Medicine, P.O. Box 670769, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
Emerg Med Clin North Am. 2002 Aug;20(3):537-52. doi: 10.1016/s0733-8627(02)00011-1.
Acute stroke care is a multidisciplinary effort. It crosses the boundaries of traditional hospital-based medicine, relying heavily on prehospital providers to obtain a significant amount of clinical information. Currently, modifications of existing EMS systems are underway to support the idea that "time is brain." Dispatchers and EMS providers are vital players in the Chain of Recovery, and are challenged to perform within this new paradigm for acute stroke care. In the near future, optimal management of the acute stroke patient may include the administration of neuroprotective medications in the prehospital setting. Educational efforts targeting high risk and elderly populations also continue to be a priority for healthcare providers and public interest groups such as the NSA. Stroke victims, family members, and caregivers must all be aware of the warning signs and symptoms of stroke. The importance of using EMS during the initial phase of acute stroke cannot be overstated. Emergency physicians must lead in coordinating the resources, placing greater emphasis on educating and assessing the performance of prehospital providers [50]. These leaders must ensure that prehospital providers understand they are integral members of the stroke team, vital to improving stroke care in the community.
急性中风护理是一项多学科协作的工作。它跨越了传统医院医学的界限，严重依赖院前急救人员获取大量临床信息。目前，现有的急救医疗服务（EMS）系统正在进行改进，以支持“时间就是大脑”这一理念。调度员和EMS急救人员是康复链中的关键角色，并且面临着在这种急性中风护理新范式下开展工作的挑战。在不久的将来，急性中风患者的最佳管理可能包括在院前环境中使用神经保护药物。针对高危人群和老年人群的教育工作也仍然是医疗保健提供者和诸如美国国家中风协会（NSA）等公共利益团体的优先事项。中风患者、家庭成员和护理人员都必须了解中风的警示信号和症状。在急性中风的初始阶段使用EMS的重要性再怎么强调也不为过。急诊医生必须带头协调资源，更加重视对院前急救人员的教育和表现评估[50]。这些领导者必须确保院前急救人员明白他们是中风治疗团队不可或缺的成员，对改善社区中风护理至关重要。
