+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program

Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program

Journal of Stroke and Cerebrovascular Diseases 25(7): 1665-1670

The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke. We compared baseline characteristics and prehospital/in-hospital delay time in stroke patients treated with intravenous recombinant tissue plasminogen activator for 44 months with and without EMS use and/or PN. Intravenous thrombolytic therapy was performed on 274 patients. Of those patients, 215 (78.5%) were transported to the hospital via EMS and 59 (21.5%) were admitted via private modes of transportation. The patients who used EMS had shorter median onset-to-arrival times (62 minutes versus 116 minutes, P < .001). There was no difference in in-hospital delay time between the 2 groups. In 28 cases (13%) of EMS transport, EMS personnel called the clinical staff to notify the incoming patient. Prenotification by EMS was associated with shorter median door-to-imaging time (9 minutes versus 12 minutes, P = .045) and door-to-needle time (20 minutes versus 29 minutes, P = .011). We found that EMS use reduces prehospital delay time. However, EMS use without prenotification does not shorten in-hospital processing time in a stroke center with a systemized stroke code program.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 058057049

Download citation: RISBibTeXText

PMID: 27067887

DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.011

Related references

Impact of code stroke on thrombolytic therapy in patients with acute ischemic stroke at a secondary referral hospital in Taiwan. Journal of the Chinese Medical Association 81(11): 942-948, 2018

Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy: the NINDS Suburban Hospital Stroke Center experience. Stroke 34(6): E55-E57, 2003

Impact of prehospital stroke code in a public center in Paraguay: A pilot study. International Journal of Stroke 2019: 1747493019828643, 2019

Stroke center characteristics which influence the administration of thrombolytic therapy for acute ischemic stroke: a national survey of stroke centers in Taiwan. Journal of the Neurological Sciences 281(1-2): 24-27, 2009

Prediction of thrombolytic therapy after stroke-bypass transportation: the Maria Prehospital Stroke Scale score. Journal of Stroke and Cerebrovascular Diseases 22(4): 514-519, 2013

Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients. International Journal of Stroke 11(6): 656-662, 2017

Assessing the validity of the Cincinnati prehospital stroke scale and the medic prehospital assessment for code stroke in an urban emergency medical services agency. Prehospital Emergency Care 17(3): 348-353, 2014

Regional Intervention of Stroke Care to Increase Thrombolytic Therapy for Acute Ischemic Stroke. Stroke 49(8): 2008-2010, 2018

A systemized stroke code significantly reduced time intervals for using intravenous tissue plasminogen activator under magnetic resonance imaging screening. Journal of Stroke and Cerebrovascular Diseases 24(2): 465-472, 2015

Use of a field-to-stroke center helicopter transport program to extend thrombolytic therapy to rural residents. Stroke 34(3): 729-733, 2003

Lack of impact of paramedic training and use of the cincinnati prehospital stroke scale on stroke patient identification and on-scene time. Stroke 40(3): 754-756, 2009

Alberta Stroke Program Early CT Score-Time Score Predicts Outcome after Endovascular Therapy in Patients with Acute Ischemic Stroke: A Retrospective Single-Center Study. Journal of Stroke and Cerebrovascular Diseases 27(4): 1041-1046, 2017

The usefulness of the Kurashiki prehospital stroke scale in identifying thrombolytic candidates in acute ischemic stroke. Yonsei Medical Journal 55(2): 410-416, 2014

Predictive value of the Cincinnati Prehospital Stroke Scale for identifying thrombolytic candidates in acute ischemic stroke. American Journal of Emergency Medicine 31(12): 1699-1702, 2014

The Usefulness of the Kurashiki Prehospital Stroke Scale in Identifying Thrombolytic Candidates in Acute Ischemic Stroke. The Journal of Emergency Medicine 46(2): 300-301, 2014