Is this enough to have your stroke department head create a stroke protocol? Ask that department head how many protocols they have created/updated? What is their goal per year? We shouldn't have to setup goals and objectives for our stroke staff but look where it has gotten us in the ;past twenty years when we haven't done this. How many stroke protocols has your stroke staff setup in the past 20 years?
NONE I bet? That would be a fireable offense under my watch.
http://www.jocn-journal.com/article/S0967-5868%2814%2900482-2/abstract?rss=yes
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Department
of Neurology, General Hospital of Shen-Yang Military Region, 83 Wen Hua
Road, Shen He District, Shen Yang 110840, PR China
Received: July 4, 2013; Accepted: May 25, 2014; Published Online: July 31, 2014
Abstract
Recent
studies have suggested that combination antiplatelet therapy may be
superior to monotherapy in the treatment of acute stroke. However,
additional prospective studies are needed to confirm this finding. The
present trial compared the efficacy and safety of clopidogrel plus
aspirin versus aspirin alone in the treatment of non-cardioembolic
ischemic stroke within 72 hours of onset. Six hundred and ninety
patients aged ⩾40 years with minor stroke or transient ischemic attack
(TIA) were identified for enrollment. Experienced physicians determined
baseline National Institutes of Health Stroke Scale scores at the time
of admission. All patients were randomly allocated (1:1) to receive
aspirin alone (300 mg/day) or clopidogrel (300 mg for the first day,
75 mg/day thereafter) plus aspirin (100 mg/day). The main endpoints were
neurological deterioration, recurrent stroke, and development of stroke
in patients with TIA within 14 days of admission. After 43 patients
were excluded, 321 patients in the dual therapy group and 326 patients
in the monotherapy group completed the treatment. Baseline
characteristics were similar between groups. During the 2 week period,
stroke deterioration occurred in nine patients in the dual therapy group
and 19 patients in the monotherapy group. Stroke occurred after TIA in
one patient in the dual therapy group and three patients in the
monotherapy group. Similar numbers of adverse events occurred in both
groups. This study showed that early dual antiplatelet treatment reduced
early neurological deterioration in patients with acute ischemic
stroke, compared with antiplatelet monotherapy. These results imply that
dual antiplatelet therapy is superior to monotherapy in the early
treatment of acute ischemic stroke.
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