Time Is Brain: Prehospital Emergency Medical Services Response Times for Suspected Stroke and Effects of Prehospital Interventions
| Autor: | Ricardo A. Domingo, Rabih G. Tawk, Kingsley Abode-Iyamah, William D. Freeman, Josephine F. Huang, Alfredo Quiñones-Hinojosa, Tito Vivas-Buitrago, Ashley Rogers, Johan L. Heemskerk |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Time Factors business.industry Ambulances Psychological intervention ICD-10 Mean age General Medicine medicine.disease Stroke Treatment center Interquartile range Emergency medicine Florida Emergency medical services Humans Medicine Female Suspected stroke business Aged Retrospective Studies |
| Zdroj: | Mayo Clinic Proceedings. 96:1446-1457 |
| ISSN: | 0025-6196 |
| DOI: | 10.1016/j.mayocp.2020.08.050 |
| Popis: | To compare prehospital time for patients with suspected stroke in Florida with the American Stroke Association (ASA) time benchmarks, and to investigate the effects of dispatch notification and stroke assessment scales on prehospital time.A retrospective analysis was performed using data from Florida's Emergency Medical Services Tracking and Reporting System database. All patients with suspected stroke transported to a treatment center from January 1, 2018, through December 31, 2018, were analyzed. Time intervals from 911 call to hospital arrival were evaluated and compared with ASA benchmarks.In 2018, 11,577 patients with suspected stroke were transported to a hospital (mean age, 71.5±15.7 years; 51.5% women). The median alarm-to-hospital time was 33.98 minutes (27.8 to 41.4), with a total emergency medical services (EMS) time of 32.30 minutes (26.5 to 39.478). The on-scene time was the largest time interval with a median of 13.28 minutes (10.0 to 17.4). Emergency medical services encounters met the ASA benchmarks for time in 58% to 62% of the EMS encounters in Florida (recommended 90%; P.001). The total EMS time was reduced when a stroke notification was reported by the dispatch center (32.00 minutes vs 32.62 minutes; P=.006) or when a stroke assessment scale was used by the EMS personnel (31.88 minutes vs 32.96 minutes; P=.005).This study reveals a substantial opportunity for improvement in stroke care in Florida. Two prehospital EMS stroke interventions seem to reduce prehospital time for patients with suspected stroke. Adoption of these interventions might improve the stroke systems of care. |
| Databáze: | OpenAIRE |
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