Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2006     Volumen 31     Number 3
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UDK: 616.831-005.4-083.98 ISBN 0350-2899, 31(2006) 3 p.63-68
Original paper

Ischemic Penumbra - Target Point in Emergency Approach

Miljan Jović, Aleksandar Jolić, Miodrag Jovanović, Davor Mladenović, Petar Firović,
Maja Todorov, Dragan Ćirić
Zdravstveni centar Zaječar, Služba hitne medicinske pomoći



Improvement of general treatment in the acute phase of brain attack (stroke), prevention of complications and stroke relapse, early and late rehabilitation produced positive results in reduction of mortality and invalidity in stroke patients. Oxygenation, tension and blood sugar regulation, restitution of normal body heat and prevention of further complications are recommended as general healing methods in acute ischemic stroke. This is, in addition to patient care, practised with many variations in different countries, and also in different medical centres with a prevailing attitude that no major results can be achieved in treatment (earlier, the so called nihilistic attitude in stroke treatment). The aim of this study is to set up and adopt modern tendencies in stroke treatment, assuming an active, efficient approach to the treatment of these patients against the obsolete, nihilistic approach. What was measured in a retrospective analysis of field protocols of the Emergency Department in Zaječar in 2005 is the time elapsing from patient’s call to ambulance departure, arrival time and total time per intervention in case of acute cerebrovascular insult (I63, I64, R40). Prehospital treatment also received full consideration. The total number of field patients with the indicated diagnoses was 220 (out of 3,589 treated patients), the average patient’s call-ambulance departure time was 9.59 minutes, the average ambulance departure-arrival was 11.04 minutes, while the total time including the treatment and transport of these patients to the hospital was 51.31 minute per patient. Patients who suffered acute brain stroke were on average 73.25 years old. Treatment measures were applied in only 29 of the total number of patients.
If the period of 3 hours is taken as a benchmark for efficient stroke treatment, during which it is reasonable and effective to start urgent treatment, this being the period during which ischemic penumbra can be treated successfully, the efficiency of the Emergency Department of Zaječar in the treatment of patients with acute stroke is generally good. Factors on which no major influence can be made are the arrival time, partial and total treatment time and patient’s age. What can be influenced so as to improve the treatment of patients with acute stroke is patient’s call-ambulance departure time and medical treatment. It has to be admitted that the earlier nihilistic approach still has much influence on the treatment of these patients. The modern approach based upon theoretic knowledge and practical results would improve prognosis and patient’s outcome to a large extent.
Key words: Ischemic penumbra, prehospital treatment

: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
  Corresponding Address:
Miljan Jović
Albanske spomenice 28, 19000 Zaječar

Paper received: 21.09.2006
Paper accepted: 08.10.2006
Published online: 26.10.2006
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