Prehospital diagnostikk av hjerneslag -metodar og kliniske erfaringar, ei litteraturstudie

Abstract

In this paper I discuss technology that can exclude hemorrhagic stroke in a prehospital environment, and in this way bring down the time from stroke-alarm to treatment with intravenous alteplast. Method I search PubMed for Prehospital diagnosis of stroke AND radiology . This gave me 41 articles that included papers on prehospital CT-scanning, trans cranial ultrasound and microwave technology. I searched PubMed, Google Scholar and other resources for papers on each method. I have also searched specific journals such as IEEE trans bio med. I have also search PubMed and other engines for information relevant for my discussion. In summary I have collected 42 full text papers, and used 23 of these in my paper. Results It is just the method with prehospital CT-scanner that there have been actual studies on time reduction. These show a reduction in alarm to treatment-time of 25 and 38 minutes in central areas in Germany. There are some studies on the use of trans cranial ultrasound as a possibility for future prehospital stroke treatment, but as far as studies show; it has not been proven adequate. Studies on humans with microwave technology have just started to get published, and these show that you can detect a hemorrhagic stroke in 11 of 14 and 14 of 15 with acknowledged stroke (confirmed with CT scanner). Conclusion CT-skanner mounted in an ambulanse have shown great results in reduducing time from alarm to treatment in pasients with suspeceted stroke, but it is still uncertain if you can make it cost-effectiv. Despite that microwave technology hasn`t been tested in an prehospital invironment, this technology could prove especially useful because it could easily be customized to a ambulance og an helicopter.