KUZEY KIBRIS’TA PARAMEDİKLERİN AKUT İNMENİN TANINMASI VE HASTANE ÖNCESİ YAKLAŞIM İLE İLGİLİ BİLGİ VE TUTUMLARI

Year 2024, Volume: 33 Issue: 3, 325 - 330

Amber Eker , Asya Tahire Meşeli , Buğu Azizoğlu , Çağla Albayrak , Musbah Khdeir , Nezayet Saral , Saadet Aktuglu

https://doi.org/10.34108/eujhs.1440838

Abstract

İnme, beyne giden kan akışının kesilmesinden kaynaklanan ani bir işlev bozukluğu olarak tanımlanır. Zamanında müdahale hayati önem taşımaktadır. Akut inme vakalarında hızlı ve etkili paramedic müdahalesi oldukça kritiktir. Bu çalışmadaki amacımız, Kuzey Kıbrıs'taki paramediklerin hastane öncesi inmeye yönelik bilgi ve davranışlarını değerlendirmektir. Bu tanımlayıcı çalışmada, Kuzey Kıbrıs'taki paramediklere araştırmacılar tarafından hazırlanmış bir çevrimiçi anket uygulanmıştır. Anketten elde edilen veriler, SPSS v26 kullanılarak tanımlayıcı istatistikler ve ki-kare testleri ile analiz edildi. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bu çalışmaya ülkede aktif olarak çalışan 50 paramedikten 36'sı katılmıştır. Paramediklerin %63.9'u devlet hastanelerinde çalışmaktadır. Paramediklerin %72.2'si inme konusunda eğitimli olmasına rağmen, %61.1'i trombolitik tedavinin başlaması için uygun süreyi bilememiştir. İnme eğitimi olan paramediklerin hastane öncesi tanı skalasına ilişkin bilgileri daha yüksektir (p= 0.004). Özel hastanelerde çalışan paramedikler hastane öncesi tanı ölçeği ve inme ünitesi olan hastaneler hakkında istatistiki olarak anlamlı olarak daha az bilgiye sahiptir.
Çok kategorili değerlendirilmeler sonucunda, paramediklerin inme hakkındaki bilgilerinin ve hastane öncesi yönetimlerinin yetersiz olduğu gösterildi. Paramediklerin akut inme ve tedavisi hakkındaki bilgilerini arttırmak için periyodik eğitimler düzenlenmelidir.

Keywords

Akut inme, Kıbrıs, paramedikler, hastane öncesi inme tedavisi

Ethical Statement

Ethics approval: The study was approved by the Health Subcommittee of Eastern Mediterranean University Research and Publication Ethics Board with decision number ETK00-2021-0090 Informed Consent: Informed consent was obtained from each participant.

Supporting Institution

Yok

Thanks

This research was conducted within the Marmara University- Eastern Mediterranean University Faculty of Medicine International Joint Program , Introduction to Clinical Skills-2 Research program. Additionally, we would like to express special thanks to Cyprus Paramedic Association for their contributions to this study.

ATTITUDES AND KNOWLEDGE OF PARAMEDICS ABOUT RECOGNITION OF ACUTE STROKE AND PRE-HOSPITAL STOKE CARE IN NORTHERN CYPRUS*

Abstract

A Stroke is defined as a sudden dysfunction caused by the interruption of blood flow to the brain. Timely intervention is vital, making rapid and effective paramedic response critical. In this study, our purpose is to evaluate the knowledge and behaviors of paramedics toward pre-hospital stroke care in Northern Cyprus. In this descriptive study, an online questionnaire that was prepared by researchers was distributed to paramedics in Northern Cyprus. The data from the survey were analyzed with descriptive statistics and chi-square tests by using SPSS v26. The value of p<0.05 is accepted as statistically significant. 36 out of 50 active paramedics participated in the study. 63.9% of paramedics work in public hospitals. Although 72.2% of paramedics are educated in stroke, 61.1% of paramedics could not estimate the exact time period for the initiation of thrombolytic therapy. Paramedics who have stroke education have higher knowledge of the pre-hospital diagnosis scale (p=0.004). Private hospital paramedics have significantly less knoeledge of pre-hostpital diagnosis scale and about the hospitals with stroke unit.
Multi-categorical evaluations demonstrated inadequate knowledge andpre-hospital management of stroke among paramedics. Periodic education must be held for paramedics to improve their knowledge about pre-hospital stroke care and treatment.

Keywords

Acute stroke, Cyprus, paramedics, pre-hospital stroke care

References

• Khaku AS, Tadi P. Cerebrovascular Disease. [Updated 2021 Sep 29]. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2021
• GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20(10):795-820. doi:10.1016/S1474-4422(21)00252-0
• Rajajee V, Saver J. Prehospital care of the acute stroke patient. Tech Vasc Interv Radiol. 2005;8(2):74-80. doi:10.1053/j.tvir.2005.03.004. doi:10.1186/s13012-016-0524-1
• Craig LE, Mc Innes E, Taylor N et al. Identifying the barriers and enablers for a triage, treatment, and transfer clinical intervention to manage acute stroke patients in the emergency department: a systematic review using the theoretical domains framework (TDF). Implement Sci. 2016 Nov 28.
• Reeves MJ, Arora S, Broderick J Pet al. Acute stroke care in the US: results from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry. Stroke. 2005;36(6):1232-1240. doi:10.1161/01. STR.0000165902.18021.5b
• Selcuk F, Mut S, Incirli SU, Akalın T. Stroke Incidence, Risk Factors and Mortality Rates in Northern Cyprus. Turkiye Klinikleri J Neur. 2014;9(1):1-8
• Powers WJ, Rabinstein AA, Ackerson Tet al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.000000000000 0211
• Mattila OS, Puolakka T, Ritvonen J et al. Targets for improving dispatcher identification of acute stroke. Int J Stroke. 2019;14(4):409-416. doi:10.117 7/1747493019830315
• Wardhana RK, Basuki A, Suryosutanto. Profile of knowledge on stroke among paramedics at jatinangor and tanjungsari public health centers. Althea Med J. 2016;3(3):355–358. doi:10.15850/amj.v3n3.879
• Brandler ES, Sharma M, McCullough F et al. Prehospital Stroke Identification: Factors Associated with Diagnostic Accuracy. J Stroke Cerebrovasc Dis. 2015;24(9):2161-2166. doi:10.1016/j.jstrokecere brovasdis.2015.06.004
• Fothergill RT, Williams J, Edwards MJ, Russell IT, Gompertz P. Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians? Stroke. 2013;44(11):3007-3012. doi:10.11 61/STROKEAHA.13.000851
• Asadi P, Monsef Kasmaei V, Zia Ziabari SM, Bakian S, Noyani A. Assessment of awareness and attitude of EMS personnel concerning pre-hospital stroke care based on American Stroke Association Guideline. J Emerg Pr Trauma. 2020;6(2):68–72. doi:10.34172/jept.2020.05
• Shire F, Kasim Z, Alrukn S, Khan M. Stroke awareness among Dubai emergency medical service staff and impact of an educational intervention. BMC Res Notes. 2017;10(1):255. doi:10.1186/s13104-017-2585-x
• Frendl DM, Strauss DG, Underhill BK, Goldstein LB. Lack of impact of paramedic training and use of the cincinnati prehospital stroke scale on stroke patient identification and on-scene time. Stroke. 2009;40(3):754-756. doi:10.1161/STROKEAHA. 108.531285
• Ramanujam P, Guluma KZ, Castillo EM et al. Accuracy of stroke recognition by emergency medical dispatchers and paramedics--San Diego experience. Prehosp Emerg Care. 2008;12(3):307-313. doi:10.1080/10903120802099526
• Williams TA, Blacker D, Arendts G, Patrick E, Brink D, Finn J. Accuracy of stroke identification by paramedics in a metropolitan prehospital setting: a cohort study. Australasian Journal of Paramedicine [Internet]. 2017Apr.30 [cited 2021Dec.17];14(2)
• Di Biasio EL, Jayaraman MV, Oliver Let al. Emergency medical systems education may improve knowledge of pre-hospital stroke triage protocols. J Neurointerv Surg. 2020;12(4):370-373. doi:10.11 36/neurintsurg-2018-014108;11(1):157
• Bouckaert M, Lemmens R, Thijs V. Reducing prehospital delay in acute stroke. Nat Rev Neurol. 2009;5(9):477-483. doi:10.1038/nrneurol.2009. 116
• Caceres JA, Adil MM, Jadhav V et al. Diagnosis of stroke by emergency medical dispatchers and its impact on the prehospital care of patients. J Stroke Cerebrovasc Dis. 2013;22(8):e610-614. doi:10.10 16/j.jstrokecerebrovasdis.2013.07.039
• Mosley I, Nicol M, Donnan G, Patrick I, Kerr F, Dewey H. The impact of ambulance practice on acute stroke care. Stroke. 2007;38(10):2765-2770. doi:10.1161/STROKEAHA.107.483446
• Puolakka T, Strbian D, Harve H, Kuisma M, Lindsberg PJ. Prehospital Phase of the Stroke Chain of Survival: A Prospective Observational Study. J Am Heart Assoc. 2016;5(5):e002808. doi:10.1161/JAHA.115.002808
• Li T, Munder SP, Chaudhry A, Madan R, Gribko M, Arora R. Emergency Medical Services Providers' Knowledge, Practices, And Barriers To Stroke Management. Open Access Emerg Med. 2019;15(11):297-303. doi:10.2147/OAEM.S228240
• Wojner-Alexandrov AW, Alexandrov AV, Rodriguez D, Persse D, Grotta JC. Houston paramedic and emergency stroke treatment and outcomes study (HoPSTO). Stroke. 2005;36(7):1512-1518. doi:10.1161/01.STR.0000170700.45340.39