J Emerg Med
-
Prehospital delays in the treatment of stroke patients, including identification of stroke as a medical emergency, represent a significant and preventable obstacle to optimal stroke care. Although patient delay in seeking care represents the greatest barrier to expedient care, delays often exist in the identification, transport, and triage of stroke patients. ⋯ In addition, emergency physicians must be engaged in the effort to limit delays if the rates of patients eligible for thrombolytic therapy are to improve. This review presents the common inadequacies in the prehospital identification and care for stroke patients and discusses changes within the community health care system that can be implemented to improve the critical early stages of stroke management.
-
The long-axis technique for ultrasound-guided vascular access may benefit users attempting deeper targets. The purpose of this study was to determine if a difference exists in the difficulty experienced by novice ultrasound users in obtaining vascular access in long axis with linear vs. curvilinear transducers. Subjects obtained access on simulated peripheral veins in a gel model. ⋯ The difference in time to cannulation with the linear and curvilinear transducers was not statistically significant. Novice ultrasound users found the curvilinear transducer easier to use for simulated vascular access in the long axis. Studies utilizing live patients and more experienced ultrasonographers could determine whether the preference for the curvilinear transducer amounts to clinically meaningful shorter times to needle entry and more successful first attempts.