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Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina stroke care collaborative.

Publication ,  Journal Article
Patel, MD; Rose, KM; O'Brien, EC; Rosamond, WD
Published in: Stroke
August 2011

BACKGROUND AND PURPOSE: Individuals with stroke-like symptoms are recommended to receive rapid diagnostic evaluation. Emergency medical services (EMS) transport, compared with private modes, and hospital notification before arrival may reduce delays in evaluation. This study estimated associations between hospital arrival modes (EMS or private and with or without EMS prenotification) and times for completion and interpretation of initial brain imaging in patients with presumed stroke. METHODS: Among patients with suspected stroke identified and enrolled by the North Carolina Stroke Care Collaborative registry in 2008 to 2009, we analyzed data on arrival modes, meeting recommended targets for brain imaging completion and interpretation times (<25 minutes and <45 minutes since hospital arrival, respectively) and patient- and hospital-level characteristics. We used modified Poisson regression to estimate adjusted risk ratios and 95% CIs. RESULTS: Of 13 894 eligible patients, 21% had their brain imaging completed and 23% had their brain imaging interpreted by a physician within target times. Arrival by EMS (versus private transport) was associated with both brain imaging completed within 25 minutes of arrival (EMS with prenotification: risk ratio, 3.0; 95% CI, 2.1 to 4.1; EMS without prenotification: risk ratio, 1.9; 95% CI, 1.6 to 2.3) and brain imaging interpreted within 45 minutes (EMS with prenotification: risk ratio, 2.7; 95% CI, 2.3 to 3.3; EMS without prenotification: risk ratio, 1.7; 95% CI, 1.4 to 2.1). CONCLUSIONS: Patients with presumed stroke arriving to the hospital by EMS were more likely to receive brain imaging and have it interpreted by a physician in a timely manner than those arriving by private transport. Moreover, EMS arrivals with hospital prenotification experienced the most rapid evaluation.

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Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

August 2011

Volume

42

Issue

8

Start / End Page

2263 / 2268

Location

United States

Related Subject Headings

  • Time Factors
  • Stroke
  • Radiography
  • North Carolina
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Patel, M. D., Rose, K. M., O’Brien, E. C., & Rosamond, W. D. (2011). Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina stroke care collaborative. Stroke, 42(8), 2263–2268. https://doi.org/10.1161/STROKEAHA.110.605857
Patel, Mehul D., Kathryn M. Rose, Emily C. O’Brien, and Wayne D. Rosamond. “Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina stroke care collaborative.Stroke 42, no. 8 (August 2011): 2263–68. https://doi.org/10.1161/STROKEAHA.110.605857.
Patel, Mehul D., et al. “Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina stroke care collaborative.Stroke, vol. 42, no. 8, Aug. 2011, pp. 2263–68. Pubmed, doi:10.1161/STROKEAHA.110.605857.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

August 2011

Volume

42

Issue

8

Start / End Page

2263 / 2268

Location

United States

Related Subject Headings

  • Time Factors
  • Stroke
  • Radiography
  • North Carolina
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Female