Primärversorgung von Schlaganfallpatienten

Zusammenfassung

Schlaganfälle sind die dritthäufigste Todesursache in unserer Gesellschaft. Die Behandlung des ischämischen Schlaganfalls hat in den letzten Jahren durch die Einführung der systemischen Lysebehandlung und von spezialisierten Behandlungszentren, den Stroke Units, wesentliche Fortschritte gemacht. Das Zeitfenster für die systemische Lysebehandlung nach Symptombeginn beträgt bei Schlaganfallpatienten nur drei Stunden, somit ist die unmittelbare Einweisung von Schlaganfallpatienten in eine Stroke Unit die für das Outcome des Patienten entscheidende Maßnahme. Die Entscheidungen des Notarztes vor Ort über Transportweg und Zielkrankenhaus sind daher wegweisend für die weiteren Behandlungsmöglichkeiten. Es werden die diagnostischen Kriterien des Schlaganfalls und seiner Differenzialdiagnosen und das Vorgehen vom Notruf des Patienten bis zur Einlieferung in eine Stroke Unit anhand von Empfehlungen dargestellt.

Abstract

Cerebral stroke is the third most frequent cause of death in our society. Stroke Units and systemic lysis therapy has had a major impact on the treatment of stroke vicitims. The time window for systemic lysis in cerebral ischemia is only three hours, therefore immediate admission to a stroke unit is of outmost importance and will have a significant effect on the outcome. This requires a high level of awareness of all members of the rescue chain. The choices made by the emergency physicians on the scene concerning transportation and admission hospital will greatly influence the therapeutic options. This review focuses on the clinical criteria suggesting stroke and lists the guidelines for referral and initial treatment in acute stroke from the call to the emergency medical service to the admission in the stroke unit.

Schlüsselwörter

Schlaganfall - Prähospitalphase - rt-PA Lyse - Stroke Unit

Key words

Stroke - prehospital care - rt-PA lysis - stroke unit

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