Published online before print July 3, 2003, doi: 10.1161/01.STR.0000080943.59701.0D
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2003;34:1918.)
© 2003 American Heart Association, Inc.
Original Contributions |
Feasibility of Neuroprotective Agent Administration by Prehospital Personnel in an Urban Setting
From the Department of Emergency Medicine, West Virginia University (T.C., S.M.D., B.T.), Morgantown, W Va, and the Departments of Emergency Medicine (T.G., N.F., E.J., B.P., M.O., A.P.), Neurology (L.S.), and Biostatistics (T.C.), University of Cincinnati, Ohio.
Correspondence to Todd Crocco, MD, Assistant Professor, West Virginia University, Morgantown, WV 26506-9149. E-mail tcrocco{at}hsc.wvu.edu
Background and Purpose— Studies have demonstrated the importance of early stroke treatment. If a neuroprotective agent (NA) clinical trial is successful, the greatest benefit might be attained with early prehospital administration. This study determined the potential reduction in time to treatment of stroke patients when NAs were administered in the prehospital setting.
Methods— Twenty-three urban emergency medical services (EMS) agencies participated in this study. Prehospital personnel completed a stroke assessment checklist on any potential stroke victim. The checklist collected clinical inclusion/exclusion criteria for NA administration and event/decision times. Patients meeting the hypothetical clinical inclusion criteria were enrolled into this study. Time data included scene arrival/departure, emergency department (ED) arrival, and estimated time of theoretical NA administration. The reduction in time to stroke treatment was calculated as the difference between the time of ED arrival and the reported time of NA administration. The t test and simple linear regression were used to probe for differences in treatment time reduction between selected subgroups. EMS personnel’s ability to obtain informed consent for theoretical NA administration was calculated.
Results— Two hundred twenty-two patients were enrolled in this study; of these, 75 were deemed eligible for hypothetical NA administration and had complete time data. On average, EMS personnel documented the theoretical time of NA administration at 12.04±2.07 minutes before arrival at the ED (17.06±1.74 minutes when the NA was given on scene [n=43]; 6.65±1.14 minutes when the NA was given en route [n=32]).
Conclusions— Prehospital NA administration can potentially significantly reduce the time to first intervention in stroke patients.
Key Words: emergency medical services • neuroprotection • stroke
This article has been cited by other articles:
 |
|
 |
|
  J. E. Acker III, A. M. Pancioli, T. J. Crocco, M. K. Eckstein, E. C. Jauch, H. Larrabee, N. M. Meltzer, W. C. Mergendahl, J. W. Munn, S. M. Prentiss, et al. Implementation Strategies for Emergency Medical Services Within Stroke Systems of Care: A Policy Statement From the American Heart Association/ American Stroke Association Expert Panel on Emergency Medical Services Systems and the Stroke Council Stroke, November 1, 2007; 38(11): 3097 - 3115. [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Leira, D. L. Lamb, A. S. Nugent, A. Ahmed, K. J. Grimsman, W. R. Clarke, and H. P. Adams Jr Feasibility of Acute Clinical Trials During Aerial Interhospital Transfer Stroke, October 1, 2006; 37(10): 2504 - 2507. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Scott For Rich and Poor, the Message Is Still "Dial 9-1-1": But Is It Getting Through? Stroke, June 1, 2006; 37(6): 1354 - 1355. [Full Text] [PDF]
|
|
|
|
|
|
Task Force Members, L. H. Schwamm, A. Pancioli, J. E. Acker III, L. B. Goldstein, R. D. Zorowitz, T. J. Shephard, P. Moyer, M. Gorman, S. C. Johnston, et al. Recommendations for the Establishment of Stroke Systems of Care: Recommendations From the American Stroke Association's Task Force on the Development of Stroke Systems Stroke, March 1, 2005; 36(3): 690 - 703. [Full Text] [PDF]
|
|
|
|
|
|
L. H. Schwamm, A. Pancioli, J. E. Acker III, L. B. Goldstein, R. D. Zorowitz, T. J. Shephard, P. Moyer, M. Gorman, S. C. Johnston, P. W. Duncan, et al. Recommendations for the Establishment of Stroke Systems of Care: Recommendations From the American Stroke Association's Task Force on the Development of Stroke Systems Circulation, March 1, 2005; 111(8): 1078 - 1091. [Full Text] [PDF]
|
|
|
|
|
|
D. F. Hanley and W. Hacke Critical Care and Emergency Medicine Neurology Stroke, February 1, 2004; 35(2): 365 - 366. [Full Text] [PDF]
|
|