What does "brain stroke dnt" mean?

Written by Tang Ying
Physical Medicine and Rehabilitation
Updated on August 31, 2024
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The term "DNT" refers to the time from when an acute stroke patient arrives at the hospital to the start of intravenous thrombolytic treatment. Both domestic and international guidelines recommend the DNT to be within 60 minutes—the earlier, the better. This standard was established by the National Health and Family Planning Commission. The time it takes for pre-hospital emergency care and in-hospital medication administration is approximately 60 minutes each. It is only by improving the time from pre-hospital treatment to medication administration within this golden window that we can enhance the patient's survival rate, prognosis, and quality of life, while minimizing disability rates.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Treatment of urinary retention in stroke patients

In cases of urinary retention after a stroke, some patients experience this due to psychological factors, concerns, and the sudden need to remain in bed, making it difficult to urinate in bed since they cannot stand or squat. Therefore, the first step is to alleviate psychological factors, provide patient communication and counseling, and perform massages around the navel and abdomen, along with heat treatments, to help patients urinate on their own. In a second scenario, where the patient's condition is severe or even comatose, and they have difficulty urinating, a catheter can be placed. It's important to first try to rule out a urinary tract infection, collect a midstream urine sample for analysis, and ensure the catheter is not left in longer than necessary. Once the patient's condition improves or they regain consciousness, the catheter should be removed promptly to avoid any urinary tract infections.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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What is the goal of rehabilitation during the acute phase of a stroke?

Rehabilitation goals during the acute phase of stroke. In the acute phase, we usually can intervene with rehabilitation treatment 48 hours after the patient’s vital signs have stabilized. The main goals of rehabilitation during the acute phase are to prevent complications such as pressure ulcers, atelectasis pneumonia, urinary tract infections, deep vein thrombosis, and muscle atrophy. Additionally, it aims to improve impaired neurological functions such as sensory, motor, and speech therapies, and to enhance the patient’s ability for self-care and mobility.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation nursing for stroke patients

For the rehabilitation and nursing care of stroke patients, first and foremost, we need to monitor the patient's vital signs, food intake, sleep, as well as bowel and bladder function. Secondly, we should pay attention to their psychological state, checking for signs of tension, anxiety, and depressive emotional reactions. Thirdly, we encourage patients to overcome their illness and to establish confidence in their recovery. Fourthly, we guide patients to actively engage in physical function exercises, as well as daily activities such as eating and dressing to practice their daily living skills. Fifthly, we manage proper limb positioning and patient turning, prevent pressure sores, and also prevent a series of complications such as venous thrombosis and urinary tract infections.

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Written by Tang Bo
Neurology
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Is a stroke a cerebral infarction?

Stroke includes cerebral infarction. Stroke is divided into ischemic stroke and hemorrhagic stroke. Therefore, ischemic stroke is cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Thus, one cannot say it is solely a cerebral infarction; it includes cerebral infarction. If symptoms of stroke appear, such as unclear speech or limb weakness, it might be either hemorrhagic or ischemic stroke. In such cases, it is crucial to seek medical attention immediately. For hemorrhagic stroke, one should visit the neurosurgery department, and for ischemic stroke, the neurology department is appropriate. Initially, a CT scan should be performed to make a clear diagnosis.

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Written by Sheng Wang
Neurology
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Causes of Dysphagia after Stroke

The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.