Abstract T MP107: Measurement of Acute Brain Hemorrhage in the Pre-hospital Setting
Purpose: Delay in identification and treatment of hemorrhagic stroke can result in severe disability and death. Differentiation of acute stroke is essential to successful emergency treatment and patient outcome. A head CT scan is the gold standard for identifying hemorrhagic stroke. This pilot study evaluates utilization of a handheld infra-red screening device for possible detection of hemorrhagic stroke in the pre-hospital setting.
Methods: The study involved collaboration with regional emergency medical services. Device education and competencies were completed by all paramedics. A stroke assessment form was utilized in conjunction with the device on all patients experiencing signs and symptoms of acute stroke. Data obtained by the device was compared to the initial head CT scan obtained in the hospital Emergency Trauma Center.
Results: A total of 46 patients were enrolled in this pilot study. The device and head CT data were evaluated on ability to detect the presence of hemorrhagic stroke. Of the 46 patients, 7 patients were admitted with hemorrhagic stroke after positive head CT results. Out of these 7 patients, 5 had positive device results. There were 14 patients admitted with a diagnosis of acute ischemic stroke, 8 of these patients had false positive device results. Stroke mimic enrollment included 25 patients, 15 with false positive device results.
Conclusion: The handheld infra-red screening device detected all hemorrhagic stroke cases that were within the detection abilities of the system. Large vessel ischemic strokes scanned by EMS demonstrated increased blood flow and on the opposite side of the ischemic lesion. Stroke mimics included cardiac abnormality, seizure and dehydration. Several challenges in the use of the device are noted. The 2-3 minutes it took EMS to scan correctly, was too long for scanning stroke patients, decreasing this measurement time appeared to contribute to false positive results. Measurements performed during fast ambulance transport appeared to also cause false positive readings. Difficulty to achieve reliable measurement was also noted with combative and epileptic patients. EMS feedback was provided to the device manufacturer. The researchers recommend continued research to support this effort.
Author Disclosures: D. Murphy: None. P. deKerillis: None. J. Frabizzio: None. B. Nash: None. Q. Shah: None.
- © 2015 by American Heart Association, Inc.