My god, this is so blasted simple. You get an objective diagnosis. Maybe all these fourteen weren't available in 2009 but they don't even discuss getting to objective. Failure, Failure, Failure.
http://www.sciencedirect.com/science/article/pii/S1052305710000844
Misdiagnosis or delayed diagnosis of acute ischemic stroke can result in
neurologic worsening or a missed opportunity for thrombolysis. Because
stroke in young adults is less common than stroke in the elderly, we
sought to determine clinical characteristics associated with
misdiagnosis of stroke in young adults. Patients from the prospectively
maintained Young Stroke Registry in our comprehensive stroke center were
reviewed. Demographic information, past medical history, presentation
within the 3-hour time window, and outcomes were assessed. We compared
patients misdiagnosed and those correctly diagnosed to identify factors
associated with misdiagnosis of acute stroke. A total of 57 patients
aged 16-50 were enrolled in the registry during 2001-2006. Eight
patients (14%; 4 men and 4 women; mean age, 38 years) were misdiagnosed.
Seven of these 8 patients were discharged from the emergency department
initially. Patients age <35 years (P = .05) and patients with posterior circulation stroke (P
= .006) were more likely to be misdiagnosed. All 8 misdiagnosed
patients were initially evaluated at hospitals that were not certified
primary stroke centers. Patients presenting with vertebrobasilar
territory ischemia have a greater rate of misdiagnosis. Our study
demonstrates the increasing need for “young stroke awareness” among
emergency department personnel. Initial misdiagnosis can potentially
lead to a lost opportunity for thrombolysis in otherwise good
candidates.
No, what you need is an objective method for diagnosis.
I was left to lie in bed for three hours before I was seen by a doctor because I had a posterior circulstion stroke at 58. ER nurses are the one's who need better training.
ReplyDeleteBut Rebecca, that is the problem, it should be objective not subjective depending on how well you were trained.
Delete"Patients presenting with vertebrobasilar territory ischemia have a greater rate of misdiagnosis." That's exactly what I had. And Rebecca, I was left to lie in a bed for 30 hours. Don't you just love America?
ReplyDeleteYou are right Dean. Health care professionals just can't believe that a sudden onset of subjective signs like poor balance or impaired vision can be related to stroke. Since these "soft signs" are typical of vertebrobasilar strokes, ER staff let us lie in bed until hard signs like a paralysed limb show up. I even had a neurologist tell me my poor balance was probably due to an ear infection.
ReplyDelete