Análisis del manejo extrahospitalario del ictus en fase aguda en la Comunidad de Madrid durante el año 2013 por el SUMMA 112

Résumé

The outpatient management of acute stroke in the Emergency services is not well known due to the scarcity of studies on implementation of protocols and guidelines based on evidence, as most of the literature refers to hospitals. In Spain, the Stroke is the second leading cause of mortality in general and specifically the first in women and the leading cause of disability and the second of dementia in people over 65 years. The creation of stroke units and stroke code, are the best contribution to their proper management in the acute phase, with decreased morbidity and mortality. The "care chain" of the S.E.M, are a cornerstone of access to hospital with stroke unit. In the Community of Madrid are 7 network hospitals with stroke unit. The aim of this paper is to describe the performance of the SUMMA 112, since the CCU receives a call and activates the corresponding resource until arrival at the hospital once the patient handled. The study noted a stroke underdiagnosed due to poor neurological assessment, generating inadequate, such as SCA and DNNE totaling 80.2% diagnostics. Also causes the transfer of 52.7% of patients with stroke, 59.6% of TIA patients without health personnel resource and causes a high percentage of the transfer of these patients to hospitals without stroke unit. Inadequate management approach produces an operative complications in the prehospital phase. Such complications include: changes in blood pressure, blood glucose, temperature, ventilation and seizures.