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Special Issue Editor

Dr. Raúl Soto-Cámara

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Guest Editor

1. Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
2. Emergency Medical Service of Castilla y León (Sacyl), 47007 Valladolid, Spain
Interests: prehospital care; critical care; nursing; ischemic stroke; prehospital delay
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Stroke is a global public health problem—a situation that will worsen in the coming years as a result of the progressive aging of the population. Stroke is one of the main causes of death in developed countries, the first cause of acquired disability in adults and the second cause of dementia after Alzheimer’s disease. About half of patients who survive an acute stroke do not regain their independence and require long-term care. This entails a significant cost for the patient, their family and the health services.

In recent decades, advances in acute stroke care have enabled the early detection of stroke, which has greatly improved outcomes. As a consequence, stroke has become a largely treatable disease, and time is the factor with the greatest influence on the evolution and final prognosis of the patient in the short, medium and long term. However, despite the significant efforts made to reduce stroke care time, such as the training of emergency medical services staff, the improvement of the organization of care pathways with the installation of systems such as "Code Stroke", the creation of stroke units, the advances in the field of telemedicine or the implementation of outreach campaigns aimed at the general population, only a small percentage of patients benefit from the reperfusion treatments available in the acute phase, which prevents a significant benefit at the population level.

This Special Issue dedicated to the prehospital and hospital care of stroke patients is an opportunity to provide new insights into the prehospital and hospital management of stroke in the acute phase. I invite you to contribute to this interesting Issue.

Dr. Raúl Soto-Cámara
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

stroke
delay
time factors
admission delay
early arrival
prehospital care
hospital care

Published Papers (2 papers)

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Research

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15 pages, 621 KiB

Open AccessArticle

Knowledge on Stroke Recognition and Management among Emergency Department Healthcare Professionals in the Republic of Cyprus

by Christos Rossis, Koralia A. Michail, Nicos Middleton, Maria Karanikola, Elizabeth Papathanassoglou and Meropi Mpouzika

Healthcare 2024, 12(1), 77; https://doi.org/10.3390/healthcare12010077 - 29 Dec 2023

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Abstract

Stroke is a global leading cause of death and disability. Knowledge of related guidelines is crucial for emergency department (ED) staff, influencing early diagnosis and timely treatment. We investigated Greek Cypriot ED healthcare professionals’ (nurses and physicians) knowledge in recognizing and managing stroke. A descriptive cross-sectional study spanned November 2019 to April 2020, encompassing four private and seven public EDs in the Republic of Cyprus. The data were collected through a self-reported questionnaire developed by the research team, consisting of 37 questions. Eight questions focused on sociodemographic and employment characteristics, twenty-eight assessed knowledge in stroke recognition and management (each item was equally weighted without deliberate prioritization), and one question addressed self-assessment of knowledge in stroke care. A total of 255 nurses (response rate (RR): 74.1%) and 26 physicians (RR: 47.3%) completed the questionnaire. The average correct response rate was 12.9 out of 28 statements (SD: 4.2), with nurses and physicians scoring 12.6 (SD: 4.1) and 15.7 (SD: 4), respectively. Work experience significantly influenced stroke knowledge, with all groups demonstrating superiority over those with less than one year of experience. Participants with previous training scored an average of 1.45 additional correct answers while educational attainment did not significantly influence stroke knowledge. Investigating stroke knowledge among emergency department nurses and physicians in the Republic of Cyprus revealed significant deficits. This study stresses targeted interventions, including education, yearly examinations, workshops with hands-on training, and repeated training, to address these gaps and enhance the overall stroke care capabilities of the healthcare professionals. Full article

(This article belongs to the Special Issue Prehospital and Hospital Care for Stroke Patients)

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15 pages, 1099 KiB

Open AccessSystematic Review

Physiological Variability during Prehospital Stroke Care: Which Monitoring and Interventions Are Used?

by Abdulaziz Alshehri, Jonathan Ince, Ronney B. Panerai, Pip Divall, Thompson G. Robinson and Jatinder S. Minhas

Healthcare 2024, 12(8), 835; https://doi.org/10.3390/healthcare12080835 - 15 Apr 2024

Viewed by 406

Abstract

Prehospital care is a fundamental component of stroke care that predominantly focuses on shortening the time between diagnosis and reaching definitive stroke management. With growing evidence of the physiological parameters affecting long-term patient outcomes, prehospital clinicians need to consider the balance between rapid transfer and increased physiological-parameter monitoring and intervention. This systematic review explores the existing literature on prehospital physiological monitoring and intervention to modify these parameters in stroke patients. The systematic review was registered on PROSPERO (CRD42022308991) and conducted across four databases with citation cascading. Based on the identified inclusion and exclusion criteria, 19 studies were retained for this review. The studies were classified into two themes: physiological-monitoring intervention and pharmacological-therapy intervention. A total of 14 included studies explored prehospital physiological monitoring. Elevated blood pressure was associated with increased hematoma volume in intracerebral hemorrhage and, in some reports, with increased rates of early neurological deterioration and prehospital neurological deterioration. A reduction in prehospital heart rate variability was associated with unfavorable clinical outcomes. Further, five of the included records investigated the delivery of pharmacological therapy in the prehospital environment for patients presenting with acute stroke. BP-lowering interventions were successfully demonstrated through three trials; however, evidence of their benefit to clinical outcomes is limited. Two studies investigating the use of oxygen and magnesium sulfate as neuroprotective agents did not demonstrate an improvement in patient’s outcomes. This systematic review highlights the absence of continuous physiological parameter monitoring, investigates fundamental physiological parameters, and provides recommendations for future work, with the aim of improving stroke patient outcomes. Full article

(This article belongs to the Special Issue Prehospital and Hospital Care for Stroke Patients)

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