Prehospital time intervals and management of ischemic stroke patients.
Am J Emerg Med
; 42: 127-131, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-32059935
ABSTRACT
OBJECTIVE:
Quantify prehospital time intervals, describe prehospital stroke management, and estimate potential time saved if certain procedures were performed en route to the emergency department (ED).METHODS:
Acute ischemic stroke patients who arrived via emergency medical services (EMS) between 2012 and 2016 were identified. We determined the following prehospital time intervals chute, response, on-scene, transport, and total prehospital times. Proportions of patients receiving the following were determined Cincinnati Prehospital Stroke Scale (CPSS) assessment, prenotification, glucose assessment, vascular access, and 12-lead electrocardiography (ECG). For glucose assessment, ECG acquisition, and vascular access, the location (on-scene vs. en route) in which they were performed was described. Difference in on-scene times among patients who had these three interventions performed on-scene vs. en route was assessed.RESULTS:
Data from 870 patients were analyzed. Median total prehospital time was 39 min and comprised the following chute time 1 min; response time 9 min; on-scene time 15 min; and transport time 14 min. CPSS was assessed in 64.7% of patients and prenotification was provided for 52.0% of patients. Glucose assessment, vascular access initiation, and ECG acquisition was performed on 84.1%, 72.6%, and 67.2% of patients, respectively. 59.0% of glucose assessments, 51.2% of vascular access initiations, and 49.8% of ECGs were performed on-scene. On-scene time was 9 min shorter among patients who had glucose assessments, vascular access initiations, and ECG acquisitions all performed en route vs. on-scene.CONCLUSIONS:
On-scene time comprised 38.5% of total prehospital time. Limiting on-scene performance of glucose assessments, vascular access initiations, and ECG acquisitions may decrease prehospital time.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Serviços Médicos de Emergência
/
Tempo para o Tratamento
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AVC Isquêmico
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article