Critical Nurses in Emergency Department with Ischaemic Stroke

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NURSING
FEBRUARY 7, 2020
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Contents
Introduction.................................................................................................................... 2
Literature search strategy................................................................................................... 3
Literature review............................................................................................................. 4
Introduction................................................................................................................ 4
Ischaemic stroke........................................................................................................... 5
Role of Nurses in emergency department with acute ischaemic stroke.........................................7
Conclusion................................................................................................................... 17
Recommendation........................................................................................................... 18
References................................................................................................................... 21

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Introduction
It is very critical to provide care in initial hours for the better and long-term recovery of the
patient. The stroke is the medical emergency in that case. The robust evidence states the
substantial reduction in the death along with disability with earlier intervention in acute stroke
care, like thrombolysis as well as antiplatelet therapy stroke-unit care. International clinical
guidelines for stroke render significant recommendation to direct clinical practice. Though,
uptakes of care depended on evidence is variable as well as less than ideal. For instance, amongst
patients with ischemic stroke, the behaviour rate with intravenous recombinant tissue-type
plasminogen activator is lower in Australia (seven per cent) and America (Five per cent). While
compared with others, it is twelve per cent in Canada and fourteen per cent in Europe.
Further, the quick identification, imaging, consultation to comprehensive stroke centre along
with management are imperative to save the brain tissue in acute stroke situation. It is evident
that every minute is important for the life of patient. The life of patient can be saved by single
minute. All the nurses in emergency department should consider saying "time is brain" while
providing treatment to patients with neurologic emergency such as acute ischemic stroke. There
is significant role of nurses in prompt recognition as well as treatment of patient having acute
stroke, primary evaluation, along with coordination of well-timed flow of patient with acute
stroke throughout health management. They should have specialization in the emergency
treatment. The nurses help the survivors with personal care problems. They also render
training to the patients to develop understanding that how to carry out fundamental task of daily
existing. The nurse helps the patient to manage common health issues, like high BP along with
diabetes that may lead stroke survivor to other stroke. The nurse enables delivery of appropriate
critical treatment on time. The nurses provide quick transfer to acute SUs for continuing

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evaluation along with provision of additional cure. All the nurses should remember the phrase
"time is brain" at the time of providing care to the patient with neurologic emergency.
The purpose of this paper is to focus on the significant contribution of nursing to the convenient
transfer of acute stroke care by rendering recommendation depended on evidence for clinical
practices procedure of care as well as model of care wherever the nurse has crucial role in the
first seventy-two hours from arrival at the emergency department. The nurses have to be careful
in stroke unit care. The following parts state wide-ranging overview of nursing as well as
emergency care for patient with acute ischemic stroke encompassing beyond initial seventy-two
hours. The main procedures related to emergency department, timely evaluation, triage, as well
as quick administration of acute stroke in the emergency department are discussed in below
mentioned parts. A prompt identification, transference to comprehensive stroke department,
primary analysis along with treatment are imperative to save brain tissues through the acute
ischemic stroke. This paper describes the options of treatment in effective manner. The role of
stakeholder is also assessed in the acute stroke intervention.
Literature search strategy
The nursing search of literature databases was undertaken using medical guidelines, medical
policies, as well as reports or statistics .The main objective of this search was to find literature on
the role of nurses in the emergency department with acute ischaemic stoke. The search was
restricted to English language articles. Only the articles of previous five years are used to find
the role of nurses in emergency department with acute ischaemic stoke. Key words as well as
medical terms used to conduct research for getting better results. The focus was made on nursing

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and its related outcomes. The researcher faced some difficulties in conducting literature review.
It is found there are certain reports, government reports, articles, general reports, as well as
website that are restricted to use. The researcher faced difficulty in getting relevant data, facts, as
well as figures related to research concern. It made complexities for the researcher. It was also
time consuming for the researcher. In addition, there was also geographical limit in conducting
literature review. It can say that it is significant topic to conduct research about the role of nurses
in emergency department with acute ischaemic stroke. A researcher conducted research by
following ethical consideration. The personal data of the patients were not leaked. In addition,
the researcher did not leak the confidential information of nurses, clinicians as well as hospitals.
In this way, the researcher tried to avoid ethical issues in conducting research. Therefore, the
researcher collected data, figures, statistic, as well as facts from some locations of United
Kingdom with approval.
Literature review
Introduction
According to the World Health Organization “the stroke is considered as quickly establishing
clinical sign of central disturbance of rational functions, long-lasting more than twenty-four
hours or causing death with no superficial reason excluding vascular origin”. The stroke is
considered as neurologic urgency with poor prediction in black. The stroke states main cause of
illness as well as death at international level. It is at the third position as most general cause of
death in technologically advanced nation that results into long-term disabilities. It is argued by
Tong et. al. (2020) that stroke is responsible for 4 million death everywhere in the world. The
stroke has different levels of severity globally. It comes from full repossession on one hand to
non-fatal events as well as fatal occasions with neurological shortfalls, as well as practical

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incapacities on other side. There are two types of risk factors. These two types are non-
modifiable along with modifiable. It is stated by Ziganshina, Abakumova and Vernay (2017) that
the non-modifiable factors are age, sexual category, competition, background of family, genetic
as well as lower birth weight. On the other hand, the changeable risk elements are diabetes
mellitus, hypertension, hyperlipidaemia, fatness, hyperhomocysteinemia, atrial fibrillation
carotid artery diseases, hypercoagulable state along with selected biomarker.
Further, the stroke enhances greatly with age. It can say that the incidence of initial stroke is
approximately 200 per 100,000 yearly with occurrence of 5 to 12 per one thousand people. There
is different stroke mortality rate in different nations. It is ranged from twenty to two hundred
fifty per 100,000 people yearly. In United Kingdom, approximately 90,000 women as well as
60,000 men die from stroke in a year. It is stated by Network et. al. (2016) that the cost of stroke
to the social services are about £ 2.3 billion yearly. It can see that there is great risk of recurrent
stroke amongst the patients. It is mentioned by Watcher et. al, (2017) that approximately
fourteen per cent of survivors who suffer stroke or TIA would have the reappearance in initial
period. There are 22 % males as well as 25 % females who would have mortality in initial period
of the primary stroke. It can see that various stroke survivors had death in eight years.
Ischaemic stroke
There are two categories of stroke. First category is Ischaemic stroke along with other is
haemorrhagic stroke. The Ischaemic stroke is accountable for 85 % of each stroke. On the other
hand, the haemorrhagic stroke is accountable for 15 % of strokes (subarachnoid 5% and
intracerebral 10 %). Muir et. al. (2017) argued that Ischaemic stroke is responsible for the
sickness as well as death in the developed nations. Approximately 8% to 12% sufferers die in
thirty days of the initial stroke. In addition, the sufferers who survive initial attack are at