PUBLIC RELEASE DATE:
5-Mar-2014
Contact: Connie Hughes Connie.Hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health
Philadelphia, Pa. (March 4, 2014) Prehospital stroke alerts by emergency medical services (EMS) personnel can shorten the time to effective treatment with "clot-busting" drugs for patients with stroke, according to a report in the March issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
Dr. Mandy J. Binning and colleagues at the Capital Institute for Neurosciences (CIN) at Capital Health, Trenton and Pennington, N.J., implemented a prehospital stroke alert (PHSA) protocol in a specialized neurological emergency department (ED) setting. The PHSA approach allows patients with probable stroke to bypass the ED and go for immediate computed tomography (CT) scanningsaving valuable minutes in emergency treatment of stroke.
Trained EMS Personnel Issue Prehospital Stroke Alerts
The PHSA system was introduced at Capital Health's two neurological EDs to facilitate emergency treatment with tissue plasminogen activator (tPA). Intravenous tPA can dissolve the clot that's causing the stroke. However, to be effective, treatment must be started within 4.5 hours after initial stroke symptoms. Ideally, the "door-to-needle" timefrom arrival at the hospital to the start of tPA treatmentshould be less than one hour.
In the PHSA approach, specialists at the CIN gave EMS personnel special training in identifying stroke patients. After training, the EMS personnel could send a prenotification to the hospital, letting the ED team know that a patient with possible stroke was on the way.
After issuing a PHSA, the EMS personnel brought the patient directly to the CT suite, bypassing the usual ED routines. They were met by the neurological emergency team, which performed a quick assessment and CT scan of the brain. If stroke was confirmed in the appropriate time frame, tPA treatment was started immediately.
The new study reports on 141 patients with prehospital stroke alerts who were stable enough to bypass the ED and go directly to CT. The EMS personnel made an accurate assessment of stroke in two thirds of patients, and correctly identified patients with neurological conditions nearly 90 percent of the time.
See the article here:
Prehospital alerts let stroke patients skip the emergency room