+ 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

Severe hemiparesis as a prehospital tool to triage stroke severity: a pilot study to assess diagnostic accuracy and treatment times



Severe hemiparesis as a prehospital tool to triage stroke severity: a pilot study to assess diagnostic accuracy and treatment times



Journal of Neurointerventional Surgery 8(8): 775-777



With the publication of the recent trials showing the tremendous benefits of mechanical thrombectomy, opportunities exist to refine prehospital processes to identify patients with larger stroke syndromes. We retrospectively reviewed consecutive patients who were brought via scene flight from rural parts of the region to our institution, from December 1, 2014 to June 5, 2015, with severe hemiparesis or hemiplegia. We assessed the accuracy of the diagnosis of stroke and the number of patients requiring endovascular therapy. Moreover, we reviewed the times along the pathway of patients who were treated with endovascular therapy. 45 patients were brought via helicopter from the field to our institution. 27 (60%) patients were diagnosed with an ischemic stroke. Of these, 12 (26.7%) were treated with mechanical thrombectomy and 6 (13.3%) with intravenous tissue plasminogen activator alone. An additional three patients required embolization procedures for either a dural arteriovenous fistula or cerebral aneurysm. Thus a total of 15 (33%) patients received an endovascular procedure and 21/45 (46.7%) received an acute treatment. For patients treated with thrombectomy, the median time from first medical contact to groin puncture was 101 min, with 8 of the 12 patients (66.7%) being discharged to home. We have presented a pilot study showing that severe hemiparesis or hemiplegia may be a reasonable prehospital tool in recognizing patients requiring endovascular treatment. Patients being identified earlier may be treated faster and potentially improve outcomes. Further prospective controlled studies are required to assess the impact on outcomes and cost effectiveness using this methodology.

Please choose payment method:






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

Accession: 058838306

Download citation: RISBibTeXText

PMID: 26276076

DOI: 10.1136/neurintsurg-2015-011940


Related references

A pilot study examining the speed and accuracy of triage for simulated disaster patients in an emergency department setting: Comparison of a computerized version of Canadian Triage Acuity Scale (CTAS) and Simple Triage and Rapid Treatment (START) methods. Cjem 19(5): 364-371, 2016

The diagnostic accuracy of the HITSNS prehospital triage rule for identifying patients with significant traumatic brain injury: a cohort study. European Journal of Emergency Medicine 23(1): 61-64, 2016

Evaluation of a simple tool to assess the results of Ponseti treatment for use by clubfoot therapists: a diagnostic accuracy study. Journal of Foot and Ankle Research 12: 14, 2019

Prehospital stroke triage and transport times in a tiered emergency medical services system. Stroke 30(1): 264, 1999

Prospective Prehospital Evaluation of the Cincinnati Stroke Triage Assessment Tool. Prehospital Emergency Care 21(4): 481-488, 2017

Nurses' accuracy and self-perceived ability using the Emergency Severity Index triage tool: a cross-sectional study in four Swiss hospitals. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 23: 62, 2016

Maximizing efficiency and diagnostic accuracy triage of acute stroke patients: A case-control study. Interventional Neuroradiology 22(3): 304-309, 2017

Improved prehospital triage of patients with stroke in a specialized stroke ambulance: results of the pre-hospital acute neurological therapy and optimization of medical care in stroke study. Stroke 46(3): 740-745, 2015

Ambulance smartphone tool for field triage of ruptured aortic aneurysms (FILTR): study protocol for a prospective observational validation of diagnostic accuracy. Bmj Open 6(10): E011308, 2016

Prehospital stroke scales in a Belgian prehospital setting: a pilot study. European Journal of Emergency Medicine 17(1): 2-6, 2010

Prehospital Stroke Identification: Factors Associated with Diagnostic Accuracy. Journal of Stroke and Cerebrovascular Diseases 24(9): 2161-2166, 2016

Diagnostic Accuracy of Baseline Distal-to-Aortic Pressure Ratio to Assess Coronary Stenosis Severity: A Post-Hoc Analysis of the ADVISE II Study. Jacc. Cardiovascular Interventions 8(6): 834-836, 2016

Design and validation of a prehospital scale to predict stroke severity: Cincinnati Prehospital Stroke Severity Scale. Stroke 46(6): 1508-1512, 2015

Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. International Journal of Emergency Medicine 11(1): 3, 2018

Accuracy of prehospital triage of trauma patients by emergency physicians: a retrospective study in western Switzerland. European Journal of Emergency Medicine 18(2): 86-93, 2011