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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9503615 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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