Abstract NS9: Symptom Onset to ED Arrival Time Decreases with a Simple Public Education Campaign
Background: Most patients with acute ischemic stroke arrive at an Emergency Department (ED) too late to be eligible for treatment with IV t-PA. Educational programs have had variable success in improving public knowledge of stroke symptoms and the need to call 9-1-1 for expedited hospital transport. Duke University Hospital (DUH) implemented a 3-month long campaign of stroke-related educational signs on city buses and full page news print advertisements in Durham County, NC between May 1 and July 31, 2010. Education was focused on stroke symptoms and 9-1-1 activation. This study determined if there was a change in symptom onset to ED arrival time associated with the educational intervention.
Methods: Patients with acute stroke/TIA arriving at Durham’s tertiary care hospital (DUH) were identified based on ED ICD-9 CM codes (430-436). We measured symptom onset to arrival delay during the 6-months before and after the educational campaign for Durham residents (based on residence zip codes) compared to controls (non-residents who were transported from adjacent counties).
Results: The study sample included 270 patients with an ED encounter for ischemic stroke/TIA (112 Durham County residents and 158 non-residents). The mean symptom onset to ED arrival time decreased from 278.3(+ 464.4) min before to 229.6 (+314.8) min after the campaign for Durham County residents, whereas the delay increased from 329.5 (+346.5) min to 410.4 (+472.2) min for non-residents over the same period.
Conclusion: These data suggest that a simple public educational campaign can have a meaningful impact on reducing delays between symptom onset and ED arrival, potentially increasing the numbers of stroke patients eligible for treatment with IV-tPA.
- © 2012 by American Heart Association, Inc.