PubMed · 14639987
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Sonia M Astle, Eileen V Caulfield. 2003. Bedside tracheostomy: a step by step guide.. https://pubmed.ncbi.nlm.nih.gov/14639987/
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Since stroke has become a medical emergency because intravenous tissue plasminogen activator improves outcome after ischemic stroke within 3 h of symptom onset, the focus of acute stroke management lies on the prehospital phase. Having the worst median time of emergency department arrival after stroke onset according to nationwide statistics, we examined the factors influencing a late admission of 174 consecutive patients to our stroke unit and the effects of a public campaign over 5 months. The median time from symptom onset to arrival was 5.2 h; 36.4% of patients presented within 3 h at hospital. A high level of education, knowledge of the time window, direct contact with an emergency facility after stroke onset, high number of known symptoms, not living alone, and a stroke in the past were connected with an earlier presentation. The public campaign had a positive effect on median time of symptom onset to arrival from 12 h in July, 7.2 in August, 4.7 in October, 5.2 in November, and 3.2 in December 2002. This had a favorable effect on the number of thrombolysis.
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Guided by the idea of providing a stable electrolyte composition of the dialysate, the late Bernd Tersteegen designed a machine ingeniously combining the advantages of a closed tank hemodialysis system with the efficacy and bacteriological safety of a single-pass system. Several thousand dialysis sessions have been performed with this system in the chronic hemodialysis population. Recently, highly efficient (i.e. high volume) dialysis systems have been successfully introduced for the treatment of critically ill patients in the intensive care unit as extended dialysis. Furthermore, they can also be a safer, more effective and less costly alternative to traditional extracorporeal techniques in the treatment of severe intoxication. In a case-based approach, we review the increasing use of such a system.