The FAST-ED App: A Smartphone Platform for the Field Triage of Patients With Stroke
| Autor: | Raul G Nogueira, Gisele Sampaio Silva, Diogo C Haussen, Robert Keith Wages, Arthur Yancey, Carol Fleming, Michael Frankel, Fabricio O. Lima, Yu-Chih Yeh, Jonathan A. Grossberg, Jonathan J. Ratcliff, Earnest R Doss, Mehdi Bouslama, Daniel Branco, Teppei Sakano |
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| Rok vydání: | 2016 |
| Předmět: |
Weakness
Clinical Decision-Making 030204 cardiovascular system & hematology Brain Ischemia 03 medical and health sciences 0302 clinical medicine Aphasia medicine Emergency medical services Humans Stroke Advanced and Specialized Nursing business.industry Field assessment Field triage medicine.disease Decision Support Systems Clinical Triage Transportation of Patients Geographic Information Systems Neurology (clinical) Medical emergency Smartphone medicine.symptom Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Resource utilization Algorithms |
| Zdroj: | Stroke. 48(5) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose— The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. Methods— Review of the application’s platform and its development as well as the different variables, assessments, algorithms, and assumptions involved. Results— The FAST-ED (Field Assessment Stroke Triage for Emergency Destination) application is based on a built-in automated decision-making algorithm that relies on (1) a brief series of questions assessing patient’s age, anticoagulant usage, time last known normal, motor weakness, gaze deviation, aphasia, and hemineglect; (2) a database of all regional stroke centers according to their capability to provide endovascular treatment; and (3) Global Positioning System technology with real-time traffic information to compute the patient’s eligibility for intravenous tissue-type plasminogen activator or endovascular treatment as well as the distances/transportation times to the different neighboring stroke centers in order to assist Emergency Medical Services professionals with the decision about the most suitable destination for any given patient with acute ischemic stroke. Conclusions— The FAST-ED smartphone application has great potential to improve the triage of patients with acute ischemic stroke, as it seems capable to optimize resources, reduce hospital arrivals times, and maximize the use of both intravenous tissue-type plasminogen activator and endovascular treatment ultimately leading to better clinical outcomes. Future field studies are needed to properly evaluate the impact of this tool in stroke outcomes and resource utilization. |
| Databáze: | OpenAIRE |
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