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|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|
National Stroke Research Institute, Level 1 Neurosciences Building, Austin Health, 300 Waterdale Road, Heidelberg Heights Victoria 3181, Australia
|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|
Allied Health Personnel
Comprehensive Health Care
Emergency Medical Service Communication Systems
Ischemic Attack, Transient.diagnosis.therapy
|Appears in Collections:||Journal articles|
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