J Clin Neurol.  2010 Sep;6(3):138-142. 10.3988/jcn.2010.6.3.138.

Prehospital Notification from the Emergency Medical Service Reduces the Transfer and Intra-Hospital Processing Times for Acute Stroke Patients

Affiliations
  • 1Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Korea. jwkim@dau.ac.kr
  • 2Department of Neurology, Samsung Changwon Hospital, Changwon, Korea.
  • 3Busan Medical Information Centre, Busan, Korea.

Abstract

BACKGROUND AND PURPOSE
There is little information available about the effects of Emergency Medical Service (EMS) hospital notification on transfer and intrahospital processing times in cases of acute ischemic stroke.
METHODS
This study retrospectively investigated the real transfer and imaging processing times for cases of suspected acute stroke (AS) with EMS notification of a requirement for intravenous (IV) tissue-type plasminogen activator (t-PA) and for cases without notification. Also we compared the intra-hospital processing times for receiving t-PA between patients with and without EMS prehospital notification.
RESULTS
Between December 2008 and August 2009, the EMS transported 102 patients with suspected AS to our stroke center. During the same period, 33 patients received IV t-PA without prehospital notification from the EMS. The mean real transfer time after the EMS call was 56.0+/-32.0 min. Patients with a transfer distance of more than 40 km could not be transported to our center within 60 min. Among the 102 patients, 55 were transferred via the EMS to our emergency room for IV t-PA. The positive predictive value for stroke (90.9% vs. 68.1%, p=0.005) was much higher and the real transfer time was much faster in patients with an EMS t-PA call (47.7+/-23.1 min, p=0.004) than in those without one (56.3+/-32.4 min). The door-to-imaging time (17.8+/-11.0 min vs. 26.9+/-11.5 min, p=0.01) and door-to-needle time (29.7+/-9.6 min vs. 42.1+/-18.1 min, p=0.01) were significantly shorter in the 18 patients for whom there was prehospital notification and who ultimately received t-PA than in those for whom there was no prehospital notification.
CONCLUSIONS
Our results indicate that prehospital notification could enable the rapid dispatch of AS patients needing IV t-PA to a stroke centre. In addition, it could reduce intrahospital delays, particularly, imaging processing times.

Keyword

stroke; thrombolysis; prehospital notification; stroke care system

MeSH Terms

Emergencies
Emergency Medical Services
Humans
Retrospective Studies
Stroke
Tissue Plasminogen Activator
Tissue Plasminogen Activator

Figure

  • Fig. 1 Location of our stroke centre and distribution of transfer hospitals.


Cited by  2 articles

Transportation Time is Significantly Decreased in Acute Ischemic Stroke Patients Under Drip-and-Ship Paradigm for Thrombolysis
Jeong-Yeon Kim, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Jin-Heon Jeong
J Neurocrit Care. 2018;11(2):86-92.    doi: 10.18700/jnc.180058.

Feasibility of a Pre-Hospital Notification System Using Direct Calls from Paramedics of 119 EMS Ambulances for Acute Stroke Patients: Accuracy of Diagnosis and Efficacy of Shortening of Door-to-Imaging Time
Jin-Heon Jeong, Jin Young Yang, Jae-Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Myong-Jin Kang, Jae-Hyung Choi, Jae-Taeck Huh
J Neurocrit Care. 2015;8(2):98-102.    doi: 10.18700/jnc.2015.8.2.98.


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