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Stroke ems transport

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https://www.readbyqxmd.com/read/27894558/helicopter-scene-response-for-stroke-patients-a-5-year-experience
#1
Andrew Hawk, Catherine Marco, Matt Huang, Bonnie Chow
OBJECTIVE: The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. METHODS: CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27866732/impact-of-a-direct-admission-stroke-pathway-on-delays-of-admission-care-and-rates-of-intravenous-thrombolysis
#2
REVIEW
C Mouthon-Reignier, I Bonnaud, M Gaudron, S Vannier-Bernard, J-F Bodin, J-P Cottier, B De Toffol, S Debiais
INTRODUCTION: This study examined the impact of a "direct potential thrombolysis" pathway with direct admission to a neurological stroke unit (SU) on delays of admission, stroke care and proportion of patients with ischemic stroke (IS) treated with intravenous (IV) rtPA. METHODS: This prospective study included all patients admitted in the intensive SU for potential thrombolysis over a 2-month period. Data collected included the time of symptom onset, mode of transport, National Institutes of Health Stroke Scale (NIHSS) score on arrival, delays of care, delays of imaging and modalities, diagnosis and therapeutic data...
December 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27743926/improving-transfer-times-for-acute-ischemic-stroke-patients-to-a-comprehensive-stroke-center
#3
Thomas V Kodankandath, Paul Wright, Paul M Power, Marcella De Geronimo, Richard B Libman, Thomas Kwiatkowski, Jeffrey M Katz
BACKGROUND AND OBJECTIVE: The transfer of acute ischemic stroke (AIS) patients to a comprehensive stroke center (CSC) must be rapid. Delays pose an obstacle to time-sensitive stroke treatments and, therefore, increase the likelihood of exclusion from endovascular stroke therapy. This study aims to evaluate the impact of the Stroke Rescue Program, with its goal of minimizing interfacility transfer delays and increasing the number of transport times completed within 60 minutes. METHODS: The Stroke Rescue Program was initiated to facilitate the rapid transfer of AIS patients from regional primary stroke centers (PSCs) to the network's CSC...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27344100/emergency-transport-of-stroke-suspects-in-a-rural-state-opportunities-for-improvement
#4
Aliza T Brown, Feifei Wei, William C Culp, Greg Brown, Ryan Tyler, Appathurai Balamurugan, Nicolas Bianchi
INTRODUCTION: Time delay is the key obstacle for receiving successful stroke treatment. Alteplase therapy must start within 4.5 hours from stroke occurrence. Rapid transport to a primary stroke center (PSC) or acute stroke-ready hospital (ASRH) by the emergency medical system (EMS) paramedics is vital. We determined transport time and destination data for EMS-identified and -delivered stroke suspects in Arkansas during 2013. Our objective was to analyze transport time and the hospital qualification for stroke care across the state...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27246289/recognition-of-stroke-by-ems-is-associated-with-improvement-in-emergency-department-quality-measures
#5
Michael E Abboud, Roger Band, Judy Jia, William Pajerowski, Guy David, Michelle Guo, C Crawford Mechem, Steven R Messé, Brendan G Carr, Michael T Mullen
OBJECTIVE: Hospital arrival via Emergency Medical Services (EMS) and EMS prenotification are associated with faster evaluation and treatment of stroke. We sought to determine the impact of diagnostic accuracy by prehospital providers on emergency department quality measures. METHODS: A retrospective study was performed of patients presenting via EMS between September 2009 and December 2012 with a discharge diagnosis of transient ischemic attack (TIA), ischemic stroke (IS), or intracerebral hemorrhage (ICH)...
May 31, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27211803/opportunities-for-emergency-medical-services-ems-care-of-syncope
#6
Brit J Long, Luis A Serrano, Jose G Cabanas, M Fernanda Bellolio
UNLABELLED: Introduction Emergency Medical Service (EMS) systems are vital in the identification, assessment, and treatment of trauma, stroke, myocardial infarction, and sepsis patients, improving early recognition, resuscitation, and transport. Emergency Medical Service personnel provide similar care for patients with syncope. The role of EMS in the management of patients with syncope has not been reported. Hypothesis/Objective The objective of this study was to describe the management of out-of-hospital syncope by prehospital providers in an urban EMS system...
August 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27194383/prehospital-systolic-blood-pressure-is-higher-in-acute-stroke-compared-with-stroke-mimics
#7
Laura C Gioia, Rahel T Zewude, Mahesh P Kate, Kim Liss, Brian H Rowe, Brian Buck, Thomas Jeerakathil, Ken Butcher
OBJECTIVE: To assess the natural history of prehospital blood pressure (BP) during emergency medical services (EMS) transport of suspected stroke and determine whether prehospital BP differs among types of patients with suspected stroke (ischemic stroke, TIA, intracerebral hemorrhage [ICH], or stroke mimic). METHODS: A retrospective, cross-sectional, observational analysis of a centralized EMS database containing electronic records of patients transported by EMS to the emergency department (ED) with suspected stroke during an 18-month period was conducted...
June 7, 2016: Neurology
https://www.readbyqxmd.com/read/27131264/reducing-time-delays-in-the-management-of-ischemic-stroke-patients-in-northern-italy
#8
Simone Vidale, Marco Arnaboldi, Giacomo Bezzi, Giorgio Bono, Giampiero Grampa, Mario Guidotti, Patrizia Perrone, Andrea Salmaggi, Davide Zarcone, Alberto Zoli, Elio Agostoni
BACKGROUND AND PURPOSE: Thrombolysis represents the best therapy for ischemic stroke but the main limitation of its administration is time. The avoidable delay is a concept reflecting the effectiveness of management pathway. For this reason, we projected a study concerning the detection of main delays with following introduction of corrective factors. In this paper we describe the results after these corrections. MATERIALS AND METHODS: Consecutive patients admitted for ischemic stroke during a 3-months period to 35 hospitals of a macro-area of Northern Italy were enrolled...
July 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27067887/impact-of-prehospital-intervention-on-delay-time-to-thrombolytic-therapy-in-a-stroke-center-with-a-systemized-stroke-code-program
#9
Dae-Hyun Kim, Hyun-Wook Nah, Hyun-Seok Park, Jae-Hyung Choi, Myong-Jin Kang, Jae-Taeck Huh, Jae-Kwan Cha
BACKGROUND: The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program. METHODS: Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke...
July 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27018812/fire-engine-support-and-on-scene-time-in-prehospital-stroke-care-a-prospective-observational-study
#10
Tuukka Puolakka, Taneli Väyrynen, Elja-Pekka Erkkilä, Markku Kuisma
UNLABELLED: Introduction On-scene time (OST) previously has been shown to be a significant component of Emergency Medical Services' (EMS') operational delay in acute stroke. Since stroke patients are managed routinely by two-person ambulance crews, increasing the number of personnel available on the scene is a possible method to improve their performance. Hypothesis Using fire engine crews to support ambulances on the scene in acute stroke is hypothesized to be associated with a shorter OST...
June 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/26973735/acute-stroke-current-evidence-based-recommendations-for-prehospital-care
#11
Nancy K Glober, Karl A Sporer, Kama Z Guluma, John P Serra, Joe A Barger, John F Brown, Gregory H Gilbert, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci
INTRODUCTION: In the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with a suspected stroke and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. METHODS: We performed a literature review of the current evidence in the prehospital treatment of a patient with a suspected stroke and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
March 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26953776/contemporary-prehospital-emergency-medical-services-response-times-for-suspected-stroke-in-the-united-states
#12
Jennifer Schwartz, Rachel P Dreyer, Karthik Murugiah, Isuru Ranasinghe
BACKGROUND AND PURPOSE: There are no contemporary national-level data on Emergency Medical Services (EMS) response times for suspected stroke in the United States (US). Because effective stroke treatment is time-dependent, we characterized response times for suspected stroke, and examined whether they met guideline recommendations. METHODS: Using the National EMS Information System dataset, we included 911 calls for patients ≥ 18 years with an EMS provider impression of stroke...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26855299/paramedic-perspectives-on-barriers-to-prehospital-acute-stroke-recognition
#13
Evan Hodell, Shana D Hughes, Megan Corry, Sean Kivlehan, Brian Resler, Nicolas Sheon, Prasanthi Govindarajan
BACKGROUND: Emergency Medical Service (EMS) providers are tasked with rapid evaluation, stabilization, recognition, and transport of acute stroke patients. Although prehospital stroke scales were developed to assist with stroke recognition, unrecognized challenges exist in the prehospital setting that hinder accurate assessment of stroke. The goal of this qualitative study was to systematically understand the challenges and barriers faced by paramedics in recognizing stroke presentations in the field...
May 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26853845/older-adult-falls-seen-by-emergency-medical-service-providers-a-prevention-opportunity
#14
Mark Faul, Judy A Stevens, Scott M Sasser, Lisa Alee, Angela J Deokar, Deborah A Kuhls, Peter A Burke
INTRODUCTION: Among people aged ≥65 years, falling is the leading cause of emergency department visits. Emergency medical services (EMS) are often called to help older adults who have fallen, with some requiring hospital transport. Chief aims were to determine where falls occurred and the circumstances under which patients were transported by EMS, and to identify future fall prevention opportunities. METHODS: In 2012, a total of 42 states contributed ambulatory data to the National EMS Information System, which were analyzed in 2014 and 2015...
June 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/26847874/effect-of-emergency-medical-services-use-on-hospital-outcomes-of-acute-hemorrhagic-stroke
#15
Sola Kim, Sang Do Shin, Young Sun Ro, Kyoung Jun Song, Yu Jin Lee, Eui Jung Lee, Ki Ok Ahn, Taeyun Kim, Ki Jeong Hong, Yu Jin Kim
BACKGROUND: It is unclear whether the use of emergency medical services (EMS) is associated with enhanced survival and decreased disability after hemorrhagic stroke and whether the effect size of EMS use differs according to the length of stay (LOS) in emergency department (ED). METHODS: Adult patients (19 years and older) with acute hemorrhagic stroke who survived to admission at 29 hospitals between 2008 and 2011 were analyzed, excluding those who had symptom-to-ED arrival time of 3 h or greater, received thrombolysis or craniotomy before inter-hospital transfer, or had experienced cardiac arrest, had unknown information about ambulance use and outcomes...
May 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26770050/the-effect-of-emergency-medical-service-use-and-inter-hospital-transfer-on-prehospital-delay-among-ischemic-stroke-patients-a-multicenter-observational-study
#16
Hang A Park, Ki Ok Ahn, Sang Do Shin, Won Chul Cha, Young Sun Ro
The time between symptom onset and arrival at an emergency department (ED) (S2D) is a crucial time for optimal intravenous reperfusion care for ischemic stroke. We aimed to analyze the effect of emergency medical services (EMS) utilization and inter-hospital transfer on S2D in Korea. Ischemic stroke patients were prospectively enrolled from November 2007 to December 2012 in 23 tertiary and teaching hospital EDs in Korea. Of 31,443 adult ischemic stroke patients, 20,780 were categorized into 4 groups based on modes of EMS utilization and inter-hospital transfer: direct transport to destination ED by EMS (EMS direct; n=6,257, 30...
January 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/26634914/emergency-medical-services-transport-delays-for-suspected-stroke-and-myocardial-infarction-patients
#17
Ashley Pedigo Golden, Agricola Odoi
BACKGROUND: Prehospital delays in receiving emergency care for suspected stroke and myocardial infarction (MI) patients have significant impacts on health outcomes. Use of Emergency Medical Services (EMS) has been shown to reduce these delays. However, disparities in EMS transport delays are thought to exist. Therefore the objective of this study was to investigate and identify disparities in EMS transport times for suspected stroke and MI patients. METHODS: Over 3,900 records of suspected stroke and MI patients, reported during 2006-2009, were obtained from two EMS agencies (EMS 1 & EMS 2) in Tennessee...
2015: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26611219/prehospital-helicopter-air-ambulances-part-1-access-protocols-and-utilization
#18
Remle P Crowe, Roger Levine, Melissa A Bentley
OBJECTIVE: In the prehospital setting, helicopter air ambulances (HAAs) are used to bring advanced care to patients and reduce time to definitive care. Research related to emergency medical service (EMS) professionals' access to medical helicopters, protocols for HAA use, and prevalence of HAA transport for different patient types is sparse. Our first objective was to describe EMS professionals' access to HAA and the prevalence of written protocols regarding their use. Next, we looked at HAA use for specific patient types (trauma, nontraumatic chest pain, stroke, and pediatric)...
November 2015: Air Medical Journal
https://www.readbyqxmd.com/read/26600433/mobile-telestroke-during-ambulance-transport-is-feasible-in-a-rural-ems-setting-the-itreat-study
#19
Jason M Lippman, Sherita N Chapman Smith, Timothy L McMurry, Zachary G Sutton, Brian S Gunnell, Jack Cote, Debra G Perina, David C Cattell-Gordon, Karen S Rheuban, Nina J Solenski, Bradford B Worrall, Andrew M Southerland
BACKGROUND: The use of telemedicine in the diagnosis and treatment of acute stroke, or telestroke, is a well-accepted method of practice improving geographic disparities in timely access to neurological expertise. We propose that mobile telestroke assessment during ambulance transport is feasible using low-cost, widely available technology. MATERIALS AND METHODS: We designed a platform including a tablet-based end point, high-speed modem with commercial wireless access, external antennae, and portable mounting apparatus...
June 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/26587100/variability-in-criteria-for-emergency-medical-services-routing-of-acute-stroke-patients-to-designated-stroke-center-hospitals
#20
Nikolay Dimitrov, William Koenig, Nichole Bosson, Sarah Song, Jeffrey L Saver, William J Mack, Nerses Sanossian
INTRODUCTION: Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. METHODS: Each county's local emergency medical services agency (LEMSA) was queried for the presence of a stroke routing protocol...
September 2015: Western Journal of Emergency Medicine
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