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Stroke unit care, inpatient rehabilitation and early supported discharge

Helen Rodgers and Chris Price
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DOI: https://doi.org/10.7861/clinmedicine.17-2-173
Clin Med April 2017
Helen Rodgers
ANewcastle University and honorary consultant stroke physician, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
Roles: professor of stroke care
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  • For correspondence: helen.rodgers@newcastle.ac.uk
Chris Price
BNewcastle University and honorary consultant stroke physician, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
Roles: senior lecturer in stroke medicine
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    Fig 1.

    Stroke unit care reduces death and institutionalisation. Reproduced with permission from the Stroke Unit Triallists’ Collaboration.2

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    Table 1.

    Common causes of clinical deterioration following acute stroke

    NeurologicalNon-neurological
    Haemorrhagic transformation of an infarctInfection (chest or urine)
    Malignant cerebral oedemaPulmonary embolism
    Intracerebral haematoma expansionMetabolic disturbance
    Recurrent cerebral emboliMyocardial infarction
    Hydrocephalus
    Seizure
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    Box 1.
    Activities of daily living
    Personal activities of daily living, eg eating and drinking, washing, dressing
    Extended activities of daily living, eg shopping, cooking, housework
    Driving
    Work and leisure
    Arm function
    Cognition
    Cognitive impairment
    Apraxia
    Attention and concentration
    Executive function
    Memory
    Perception
    Spatial awareness
    Communication
    Aphasia
    Dysarthria
    Apraxia of speech
    Continence and constipation
    Fatigue
    Hydration and nutrition
    Mental capacity
    Mobility
    Weakness and ataxia
    Balance
    Falls and fear of falling
    Walking
    Mood and wellbeing
    Anxiety, depression and psychological distress
    Emotionalism
    Mouth care
    Pain
    Musculoskeletal pain
    Shoulder pain and subluxation
    Neuropathic pain (central post-stroke pain)
    Sensation
    Sex
    Spasticity and contractures
    Swallowing
    Vision
    Adapted from the National clinical guideline for stroke, 2016. 4
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Stroke unit care, inpatient rehabilitation and early supported discharge
Helen Rodgers, Chris Price
Clinical Medicine Apr 2017, 17 (2) 173-177; DOI: 10.7861/clinmedicine.17-2-173

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Stroke unit care, inpatient rehabilitation and early supported discharge
Helen Rodgers, Chris Price
Clinical Medicine Apr 2017, 17 (2) 173-177; DOI: 10.7861/clinmedicine.17-2-173
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  • Article
    • ABSTRACT
    • Key points
    • Stroke units
    • Medical care of stroke patients
    • Clinical deterioration
    • Temperature, blood sugar, oxygen, blood pressure
    • Fluids, swallowing, prophylactic antibiotics, feeding, oral hygiene
    • Prevention of deep-vein thrombosis and pulmonary embolism
    • Bladder, bowels and skin
    • Palliative care
    • Rehabilitation
    • Early supported discharge
    • Conclusion
    • Conflicts of interest
    • Acknowledgements
    • Author contributions
    • References
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