The clinical consequences of a pre-hospital diagnosis of stroke by the emergency medical service system. A pilot study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 07/11/2012
Wennman I et al. – In a pilot study, the concept of a pre–hospital diagnosis of stroke by an emergency medical service (EMS) nurse was associated with relatively high diagnostic accuracy in terms of stroke–related diagnoses and a short delay to arrival at a stroke unit. These data need to be confirmed in larger studies, with a concomitant evaluation of the clinical consequences and, if possible, the level of patient satisfaction as well.Methods
- Between September 2008 and November 2009, a subset of patients with presumed acute stroke in the pre–hospital setting were admitted by EMS staff directly to a stroke unit, bypassing the emergency department.
- A control group, matched for a number of background variables, was created.
- In all, there were 53 patients in the direct admission group, and 49 patients in the control group.
- The median delay from calling for an ambulance until arrival at a stroke unit was 54minutes in the direct admission group and 289minutes in the control group (p<0.0001).
- In a comparison between the direct admission group and the control group, a final diagnosis of stroke, transient ischemic attack (TIA) or the sequelae of prior stroke was found in 85 % versus 90 % (NS).
- Among stroke patients who lived at home prior to the event, the percentage of patients that were living at home after 3months was 71 % and 62 % respectively (NS).