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Journal of Brain Disease

Synopsis: An open access, peer reviewed electronic journal that covers human brain diseases and disorders.


Indexing: Pubmed indexing for NIH-funded research.

Processing time: Decision in 2 weeks for 90% of papers.

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About this journal

Journal of Brain Disease

Aims and scope:

Journal of Brain Disease is an open access, peer-reviewed journal which covers all types of human brain diseases and disorders.  Clinical practice, research, and education of brain disease science are emphasized. Adult and pediatric neurology, neurosurgery, neuroradiology, endovascular surgical neuroradiology, neuropsychiatry, neurophysiatry, neuropharmacology, neurophysiology, and neuropathology specialties are represented. 

Manuscripts on epidemiology, pathology, diagnosis, prognosis, and management of all brain diseases are welcomed.

Editorial standards and procedures:

Submissions, excluding editorials, letters to the editor and dedications, will be peer reviewed by two reviewers.  Reviewers are required to provide fair, balanced and constructive reports.  

Under our Fairness in Peer Review Policy authors may appeal against reviewers' recommendations which are ill-founded, unobjective or unfair.  Appeals are considered by the Editor in Chief or Associate Editor.

Papers are not sent to peer reviewers following submission of a revised manuscript. Editorial decisions on re-submitted papers are based on the author's response to the initial peer review report.

National Institutes of Health Public Access Policy compliant:

As of April 7 2008, the US NIH Public Access Policy requires that all peer reviewed articles resulting from research carried out with NIH funding be deposited in the Pubmed Central archive.

If you are an NIH employee or grantee Libertas Academica will ensure that you comply with the policy by depositing your paper at Pubmed Central on your behalf. 

 
 
 


Emergency Medical Services Support for Acute Ischemic Stroke Patients Receiving Thrombolysis at a Primary Stroke Center

Authors: Byron R. Spencer, Omar M. Khan, Bentley J. Bobrow and Bart M. Demaerschalk
Publication Date: 04 Mar 2009
Journal of Brain Disease 2009:1 13-17

Byron R. Spencer1, Omar M. Khan2, Bentley J. Bobrow3 and Bart M. Demaerschalk1

1Department of Neurology, 2Department of Internal Medicine, 3Department of Emergency Medicine Mayo Clinic.

Abstract

Background:  Emergency Medical Services (EMS) is a vital link in the overall chain of stroke survival. A Primary Stroke Center (PSC) relies heavily on the 9-1-1 response system along with the ability of EMS personnel to accurately diagnose acute stroke. Other critical elements include identifying time of symptom onset, providing pre-hospital care, selecting a destination PSC, and communicating estimated time of arrival (ETA).

Purpose:  Our purpose was to evaluate the EMS component of thrombolysed acute ischemic stroke patient care at our PSC.

Methods:  In a retrospective manner we retrieved electronic copies of the EMS incident reports for every thrombolysed ischemic stroke patient treated at our PSC from September 2001 to August 2005. The following data elements were extracted: location of victim, EMS agency, times of dispatch, scene, departure, emergency department (ED) arrival, recordings of time of stroke onset, blood pressure (BP), heart rate (HR), cardiac rhythm, blood glucose (BG), Glasgow Coma Scale (GCS), Cincinnati Stroke Scale (CSS) elements, emergency medical personnel field assessment, and transport decision making.

Results:  Eighty acute ischemic stroke patients received thrombolysis during the study interval. Eighty-one percent arrived by EMS. Two EMS agencies transported to our PSC. Mean dispatch-to-scene time was 6 min, on-scene time was 16 min, transport time was 10 min. Stroke onset time was recorded in 68%, BP, HR, and cardiac rhythm each in 100%, BG in 81%, GCS in 100%, CSS in 100%, and acute stroke diagnosis was made in 88%. Various diagnostic terms were employed: cerebrovascular accident in 40%, unilateral weakness or numbness in 20%, loss of consciousness in 16%, stroke in 8%, other stroke terms in 4%. In 87% of incident reports there was documentation of decision-making to transport to the nearest PSC in conjunction with pre-notification.

Conclusion:  The EMS component of thrombolysed acute ischemic stroke patients care at our PSC appeared to be very good overall. Diagnostic accuracy was excellent, field assessment, decision-making, and transport times were very good. There was still room for improvement in documentation of stroke onset and in employment of a common term for acute stroke.



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