There are new effective reperfusion therapies (thrombolysis and thrombectomie) in acute ischemic stroke which can be considered as secondary prevention treatment as they allow the diagnosis and management of stroke at early stage and thus lead to limitation of disability in case of ischemic stroke occurrence. These treatments are mostly delivered in Stroke Units and are only efficacious during a limited time window. Quick access to health services able of performing these reperfusion therapies is a key element. We have performed a simulation of geographical accessibility of these Stroke Units according to patients’ residence area to get estimation of accessibility of reperfusion therapies.
Freyssenge J, Renard F, Schott AM, Derex L, Nighoghossian N, Tazarourte K, El Khoury C. Measurement of the potential geographic accessibility from call to definitive care for patient with acute stroke. Int J Health Geogr. 2018.
As a number of acute stroke patients do not recognize stroke symptoms and go to emergency services instead of calling 15, we have conducted a trial to experiment the efficacy of a training program for emergency nurses and practitioners based on simulation. We have demonstrated its efficacy to improve the number of patients having timely access to reperfusion therapy.
Haesebaert J, Nighoghossian N, Mercier C, Termoz A, Porthault S, Derex L, Gueugniaud P-Y, Bravant E, Rabilloud M, Schott A-M, Group*. Improving Access to Thrombolysis and Inhospital Management Times in Ischemic Stroke: A Stepped-Wedge Randomized Trial. Stroke. 2018