Abstract

Background

Stroke is a time dependent medical emergency1 that requires the coordinated action of the pre and in-hospital teams to improve the results.2 We present the epidemiological characteristics of the population requesting medical attention to a private EMS identified by the telephone operator with activation of a Prehospital Stroke Code (PSC).

Method

Observational, retrospective, cross-sectional and descriptive study based on records made through the App Stroke Code v1.0 (internal development) from 01/09/2018 to 31/1/2019. n=97 cases. The data was transferred to a Microsoft Excel spreadsheet and to Epi Info v7.2.2.1 for analysis.

Results

PSC was activated in 97 cases. 58 has a suspected Stroke and in 39, the code was canceled by on-scene-EMS team due alternative prehospital diagnosis. The mean age was 78 y/o. 44patients (76%) consulted within three hours of the onset of symptoms. CINCINATTI-prehospital scale average on arrival was 2 points. 100% of patients with CINCITATTI 0–1 consulted after 3 hs (15) (p0.03). On patients with CINCINATTI-score of 3, 97% (p.0038) were hypertensive at the time of the consultation. No hypoglycaemia was found. Of the 58 suspected stroke cases, 16 received some form of reperfusion treatment (rTPA IV, thrombectomy-intraarterial rTPA or combination). The remainder 43 patients who did not receive reperfusion treatment were mainly due to: Alternative in-hospital diagnosis, out of therapeutic window and Intracranial bleeding. The average door to needle time was 37 minutes.

Conclusion

Patients more symptomatic consulted earlier 27% of the patients received reperfusion therapy, dramatically surpassing the average of our country (1% according to the RENACER registry3).

References

  • Saver JL. Time Is Brain - Quantified. Stroke 2006;37:263–266.

  • Caputo LM, Jensen J, Whaley M, et al. How a CT-Direct Protocol at an American Comprehensive Stroke Center Led to Door-to-Needle Times Less Than 30 Minutes. The Neurohospitalist 2017, Vol. 7(2) 70–73.

  • Sposato LA, Esnaola MM, Zamora R and the ReNACer Investigators. Quality of ischemic stroke care in emerging countries: the Argentinian National Stroke Registry (ReNACer). Stroke 2008 Nov;39(11):3036–41.

Conflict of interest

None.

Funding

None.

Details

Title
27 Prehospital stroke code. Experience in an argentinean emergency medical service
Author
Apesteguía, A; Savia, A; Farías, A; Muller, A; Kamijo, M; Yaryour, C; Sorkin, E; Allende, M
Pages
A10-A10
Section
Abstracts
Publication year
2019
Publication date
2019
Publisher
BMJ Publishing Group LTD
e-ISSN
20446055
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1136/bmjopen-2019-EMS.27
ProQuest document ID
2317879657
Copyright
© 2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.