Feasibility of Neuroprotective Agent Administration by Prehospital Personnel in an Urban Setting

Abstract

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.

Guidelines for the Early Management of Adults With Ischemic Stroke

“…30 Of importance for future research is the fact that it appears possible to incorporate EMS into the research process, with EMS personnel having demonstrated success in facilitating physician cell phone elicitation of consent from patients and in delivering experimental stroke therapy. 31,32 …”

Organization of prehospital medical care for patients with cerebral stroke

“…Как показали многочисленные исследования, вызов бригады скорой медицинской помощи (СМП) ассоцииро-ван с более быстрой доставкой в стационар, нежели само-стоятельное обращение пациентов в больницу (поступле-ние «самотеком») [1][2][3][4][5][6][7][8][9].…”

Telemedicine in Stroke: Potentials, Limitations and Ongoing Issues

“…Thrombolysis is only safe and effective in selected cases of cerebral infarction, and would be disastrous in the context of cerebral haemorrhage. Inherent in this model is the inability to identify cerebral haemorrhage accurately on clinical grounds (Crocco et al 2003), as well as the variability of accurate stroke diagnosis by ambulance personnel. The sensitivity of stroke diagnosis varies widely (between 61% and 94%) and positive predictive values remain low (Rajajee & Saver 2005).…”