Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10425
Title: The impact of ambulance practice on acute stroke care.
Authors: Mosley, Ian;Nicol, Marcus;Donnan, Geoffrey A;Patrick, Ian;Kerr, Fergus;Dewey, Helen M
Affiliation: National Stroke Research Institute, Level 1 Neurosciences Building, Austin Health, 300 Waterdale Road, Heidelberg Heights Victoria 3181, Australia. imosley@nsri.org.au
Issue Date: 23-Aug-2007
Citation: Stroke; A Journal of Cerebral Circulation 2007; 38(10): 2765-70
Abstract: Few patients with acute stroke are treated with alteplase, often due to significant prehospital delays after symptom onset. The aims of this study were to: (1) identify factors associated with rapid first medical assessment in the emergency department after a call for ambulance assistance, and (2) determine the impact of ambulance practice on times from the ambulance call to first medical assessment in the emergency department.During a 6-month period in 2004, all ambulance-transported patients with stroke or transient ischemic attack arriving from a geographically defined region in Melbourne, Australia (population 383,000) to one of 3 hospital emergency departments were assessed prospectively. Ambulance records including the tape recording of the call for ambulance assistance and hospital medical records, were analyzed.One hundred ninety-eight patients were included in the study. One hundred eighty-seven ambulance patient care records were complete and available for analysis. Factors associated with first medical assessment in the emergency department <60 minutes from the ambulance call and <10 minutes from hospital arrival were: Glasgow Coma Scale <13 (P<0.001 and P=0.021) and hospital prenotification (P=0.04 and P<0.001). Paramedic stroke recognition and hospital prenotification were associated with shorter times from the ambulance call to first medical assessment (P=0.001 and P<0.001).Paramedic stroke recognition and hospital prenotification are associated with shorter prehospital times from the ambulance call to hospital arrival and in-hospital times from hospital arrival to first medical assessment. This highlights the importance of including ambulance practice in comprehensive care pathways that span the whole process of stroke care.
Internal ID Number: 17717317
URI: http://ahro.austin.org.au/austinjspui/handle/1/10425
DOI: 10.1161/STROKEAHA.107.483446
URL: http://www.ncbi.nlm.nih.gov/pubmed/17717317
Type: Journal Article
Subjects: Acute Disease
Aged
Allied Health Personnel
Ambulances
Australia
Comprehensive Health Care
Emergency Medical Service Communication Systems
Female
Humans
Ischemic Attack, Transient.diagnosis.therapy
Logistic Models
Male
Multivariate Analysis
Prospective Studies
Stroke.diagnosis.therapy
Time Factors
Appears in Collections:Journal articles

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