Strokemanagement – Prähospitale Versorgung des akuten Schlaganfalls

Bei der Notfallversorgung des akuten Schlaganfalls darf keine Zeit verschwendet werden. Durch Fokussierung auf die wesentlichen Punkte müssen die Patienten möglichst schnell der am besten geeigneten Therapie zugeführt werden. Daher steht neben der prähospitalen Erstversorgung nach der ABCDE-Regel, dem Ausschluss einer Hypoglykämie und der Frage nach dem Zeitpunkt des Symptombeginns die Vorankündigung in der Klinik im Vordergrund. Per telemedizinischer Untersuchung und Ultraschalldiagnostik kann die prähospitale Phase bereits sinnvoll genutzt werden. Noch schneller können Patienten gezielt behandelt werden, wenn spezialisierte Rettungsmittel mit Computertomografie und Notfalllabor, wie das Stroke-Einsatz-Mobil (STEMO), zum Einsatz kommen und neurologische Expertise vor Ort anbieten.

Prehospital management of acute stroke is time-critical. A focused assessment of the patient using the ABCDE mnemonic, exclusion of hypoglycemia, identification of the time the patient was last seen well, and prenotification all ensure that patients receive optimal and speedy treatment. The time during the prehospital phase may be used for telemedicine consultation and for ultrasound. Further time savings can be achieved with the use of specialized stroke ambulances equipped with computed tomography scanners and point-of-care laboratory, such as the Stroke Emergency Mobile (STEMO), offering neurological expertise at the scene of emergency.

Key words

Stroke - prehospital - telemedicine - ultrasound - thrombolysis

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