Characteristics of Stroke in Prehospital Settings in Saudi Arabia: A Descriptive Analysis

Moath Alkeaid — 2023-04-19

Background: Stroke is considered a time-sensitive emergency; thus, early recognition of this condition is a crucial function of emergency medical services (EMS) and medical practitioners. In this study, we aimed to assess the characteristics observed by EMS practitioners in stroke-suspected cases.

Methodology: This is a retrospective observational study, using the data available in the registry of the Saudi Red Crescent Authority (SRCA). We collected data from the beginning of January 2018 to the end of December 2020.

Results: We reviewed 753 patients who met the study’s inclusion criteria. Participants aged 61-70 years represented 29% of the study group, and 66% of the group were male. Patients living in Makkah constituted 32.9%, while most of the patients (71.7%) were Saudi nationals. Weakness was the most common complaint, reported in 45% of patients. The most associated disease was hypertension (54.4%), whereas hypoglycaemic patients represented 0.4% of the group.

Conclusion: Weakness was the most prevalent complaint among stroke-suspected patients, and hypertension was the most associated risk factor. Blood glucose measurement and neurological examination were both included in the EMS assessment of stroke-suspected patients. This might indicate the high quality of the EMS assessment for stroke and stroke-mimickers.

Prevalence of Positive Blood Cultures in the Emergency Department of a Tertiary Hospital: A Retrospective Single-Centre Study

Osama Barakat — 2023-04-19

Background: Blood cultures (BCs) are frequently ordered during the course of investigation in emergency departments (EDs). However, there are few studies examining the clinical value of BCs and the prevalence of positive BCs in the adult ED.

Methods: This was a retrospective study conducted by reviewing patient charts to obtain all BCs collected in our ED over the course of one year. Out of 214,566 ED visits over the period from 1 July 2021 to 30 June 2022, a total of 1034 blood cultures were collected. The study was conducted in the ED of a teaching hospital in Taif, Makkah Region, Saudi Arabia, that has 500 beds for adults.

Results: The most commonly isolated organisms were Staphylococcus hominis (19.8%), Staphylococcus epidermidis (14.1%), Escherichia coli (9%), Klebsiella pneumoniae (8%), Staphylococcus capitis (7.3%), and Staphylococcus aureus (5.6%). Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa were isolated from 3.4% and 1.1% of positive blood cultures, respectively. In the context of antimicrobial sensitivity, the organisms isolated from positive BCs in this study showed the highest sensitivity to vancomycin (57.6%). This was followed by levofloxacin (48.6%), linezolid (48%), gentamycin (41.8%), amoxicillin clavulanate (39.5%), and clindamycin (39%). The highest prevalence of antimicrobial resistance was to ampicillin (42.4%). Resistance to clindamycin, azithromycin, piperacillin-tazobactam, and imipenem was 22%, 8.5%, 3.4% and 0.6%, respectively.

Conclusion: The prevalence of positive blood cultures in the ED of this tertiary hospital was high. The most commonly isolated organisms were Staphylococcus hominis, Staphylococcus epidermidis, Escherichia coli, and Klebsiella pneumoniae. Vancomycin elicited the highest antimicrobial sensitivity, followed by levofloxacin.

The Journal of Medicine, Law & Public Health

Characteristics of Stroke in Prehospital Settings in Saudi Arabia: A Descriptive Analysis

Prevalence of Positive Blood Cultures in the Emergency Department of a Tertiary Hospital: A Retrospective Single-Centre Study