Barriers to effective stroke care out of hours need to be broached

doi:10.1136/bmj.325.7364.596/a

BMJ 2002;325:596 ( 14 September )

Letters

Barriers to effective stroke care out of hours need to be broached

The first 150 words of the full text of this article appear below.

EDITOR $---$ The article by Harraf et al is a welcome addition to much needed hard data on the poor delivery of evidence based andpatient focused care in the United Kingdom.¹ The paper promptsthe need to analyse prospectively the nature of the barriers totimely assessment, investigation, and treatment of a patient presentingwith a potentially life threateningstroke.

The paper would have benefited from providing readers with the subset analysis of time to assessment, senior opinion, andcomputed tomography in the 128 hours of the week (76%) that falloutside 9 am-5 pm Monday-Friday.

In a typical emergency department 66% of patients arrive outside these normal working hours. The authors say that 28% arriveafter 1759 and before 0600, and state in their abstract that "timeof presentation did not influence time to evaluation by senior[non-emergency] doctor," but they do not provide results to supportthis.

In many departments in . . . [Full text of this article]

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Relevant Article

A multicentre observational study of presentation and early assessment of acute stroke: Farzaneh Harraf, Anil K Sharma, Martin M Brown, Kennedy R Lees, Richard I Vass, and Lalit Kalra
BMJ 2002 325: 17. [Abstract] [Full Text] [PDF]