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Implementation of the Helsinki Model at West Tallinn Central Hospital

Ischemic stroke is defined as neurological deficit caused by brain infarction. The intravenous tissue plasminogen activator, alteplase, is an effective treatment. However, efficacy of this method is time dependent. An important step in improving outcome and increasing the number of patients receivin...

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Autores principales: Gross-Paju, Katrin, Thomson, Ulvi, Adlas, Raul, Jaakmees, Helle, Kannel, Karin, Mallene, Sandra Marii, Mironenko, Svetlana, Reitsnik, Agnes, Vares, Ain, Ütt, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503615/
https://www.ncbi.nlm.nih.gov/pubmed/36143850
http://dx.doi.org/10.3390/medicina58091173
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author Gross-Paju, Katrin
Thomson, Ulvi
Adlas, Raul
Jaakmees, Helle
Kannel, Karin
Mallene, Sandra Marii
Mironenko, Svetlana
Reitsnik, Agnes
Vares, Ain
Ütt, Sandra
author_facet Gross-Paju, Katrin
Thomson, Ulvi
Adlas, Raul
Jaakmees, Helle
Kannel, Karin
Mallene, Sandra Marii
Mironenko, Svetlana
Reitsnik, Agnes
Vares, Ain
Ütt, Sandra
author_sort Gross-Paju, Katrin
collection PubMed
description Ischemic stroke is defined as neurological deficit caused by brain infarction. The intravenous tissue plasminogen activator, alteplase, is an effective treatment. However, efficacy of this method is time dependent. An important step in improving outcome and increasing the number of patients receiving alteplase is the shortening of waiting times at the hospital, the so-called door-to-needle time (DNT). The comprehensive Helsinki model was proposed in 2012, which enabled the shortening of the DNT to less than 20 min. Background and Objectives: The aim of this study was to analyze the transferability of the suggested model to the West Tallinn Central Hospital (WTCH). Materials and Methods: Since the first thrombolysis in 2005, all patients are registered in the WTCH thrombolysis registry. Several steps following the Helsinki model have been implemented over the years. Results: The results demonstrate that the number and also the percent of thrombolysed stroke patients increased during the years, from a few thrombolysis annually, to 260 in 2021. The mean DNT dropped significantly to 33 min after the implementation of several steps, from the emergency medical services (EMS) prenotification with a phone call to the neurologists, to the setting-up of a thrombolysis team based in the stroke unit. Also, the immediate start of treatment using a computed tomography table was introduced. Conclusions: In conclusion, several implemented steps enabled the shortening of the DNT from 30 to 25.2 min. Short DNTs were achieved and maintained only with EMS prenotification.
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spelling pubmed-95036152022-09-24 Implementation of the Helsinki Model at West Tallinn Central Hospital Gross-Paju, Katrin Thomson, Ulvi Adlas, Raul Jaakmees, Helle Kannel, Karin Mallene, Sandra Marii Mironenko, Svetlana Reitsnik, Agnes Vares, Ain Ütt, Sandra Medicina (Kaunas) Article Ischemic stroke is defined as neurological deficit caused by brain infarction. The intravenous tissue plasminogen activator, alteplase, is an effective treatment. However, efficacy of this method is time dependent. An important step in improving outcome and increasing the number of patients receiving alteplase is the shortening of waiting times at the hospital, the so-called door-to-needle time (DNT). The comprehensive Helsinki model was proposed in 2012, which enabled the shortening of the DNT to less than 20 min. Background and Objectives: The aim of this study was to analyze the transferability of the suggested model to the West Tallinn Central Hospital (WTCH). Materials and Methods: Since the first thrombolysis in 2005, all patients are registered in the WTCH thrombolysis registry. Several steps following the Helsinki model have been implemented over the years. Results: The results demonstrate that the number and also the percent of thrombolysed stroke patients increased during the years, from a few thrombolysis annually, to 260 in 2021. The mean DNT dropped significantly to 33 min after the implementation of several steps, from the emergency medical services (EMS) prenotification with a phone call to the neurologists, to the setting-up of a thrombolysis team based in the stroke unit. Also, the immediate start of treatment using a computed tomography table was introduced. Conclusions: In conclusion, several implemented steps enabled the shortening of the DNT from 30 to 25.2 min. Short DNTs were achieved and maintained only with EMS prenotification. MDPI 2022-08-29 /pmc/articles/PMC9503615/ /pubmed/36143850 http://dx.doi.org/10.3390/medicina58091173 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gross-Paju, Katrin
Thomson, Ulvi
Adlas, Raul
Jaakmees, Helle
Kannel, Karin
Mallene, Sandra Marii
Mironenko, Svetlana
Reitsnik, Agnes
Vares, Ain
Ütt, Sandra
Implementation of the Helsinki Model at West Tallinn Central Hospital
title Implementation of the Helsinki Model at West Tallinn Central Hospital
title_full Implementation of the Helsinki Model at West Tallinn Central Hospital
title_fullStr Implementation of the Helsinki Model at West Tallinn Central Hospital
title_full_unstemmed Implementation of the Helsinki Model at West Tallinn Central Hospital
title_short Implementation of the Helsinki Model at West Tallinn Central Hospital
title_sort implementation of the helsinki model at west tallinn central hospital
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503615/
https://www.ncbi.nlm.nih.gov/pubmed/36143850
http://dx.doi.org/10.3390/medicina58091173
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