mG-FAST, a single pre-hospital stroke screen for evaluating large vessel and non-large vessel strokes

Koussa, Roy El; Linder, Sarah; Quayson, Alicia; Banash, Shawn; MacNeal, James J.; Shah, Parshva; Brenner, Mariaelana; Levine, Ross L.; Zaidat, Osama O.; Bansal, Vibhav

doi:10.3389/fneur.2022.912119

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Some previous reports have shown that the D2P time was reduced after implementation of the prehospital stroke scale (modified Gaze-Face-Arm-Speech-Time [mG-FAST] or Japan Urgent Stroke Triage score). 11 , 12) The authors suggested that early preparation for MT before patient arrival contributed to a reduction in the D2P.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of a Local Triage System Using the Emergent Large Vessel Occlusion Screen with a Rotation System of Thrombectomy-Capable Hospitals

Takahashi,

Ono,

Moroi

et al. 2024

JNET

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Objective Early intervention with mechanical thrombectomy (MT) is expected to improve the functional outcome in patients with large vessel occlusion (LVO); however, a method for the effective detection of these patients in a prehospital setting and early transport to MT-capable hospitals has not been established. This study aimed to analyze the clinical impact and diagnostic performance of the emergent large vessel occlusion (ELVO) screen and its influence on the transportation time. Methods The emergency medical services (EMS) in one of the secondary medical areas in Akita, Japan, introduced a prehospital triage system employing an ELVO screen and a rotation system of three MT-capable hospitals on December 1, 2021. Patients who were transferred to each of the three hospitals involved in the rotation system according to a predefined priority list from December 2021 to November 2022 were included in the triage group. Patients who underwent MT in the three hospitals before the introduction of the triage system were assigned to the pre-triage group. We compared the transportation time parameters between the two groups and analyzed the performance of the ELVO screen for the diagnosis of LVOs. This study was approved by the institutional review boards of all three hospitals. Results Time parameters were compared between the 37 and 42 patients who underwent MT and had detailed data in the triage (n = 351) and pre-triage (n = 43) groups, respectively. The time from door to puncture tended to decrease in the triage group in all hospitals, with one hospital showing a statistically significant shortening of 14 min (p = 0.018). In the triage group, 209 ELVO screen-positive patients were present, with 60 (28.7%) of these having LVO. The sensitivity, specificity, positive and negative predictive values, and area under the curve of the ELVO screen to detect LVO under the present triage system were 87.0%, 47.2%, 28.7%, 93.7%, and 0.671, respectively. Conclusion The present study demonstrated that the introduction of a triage system may have shortened the time required for MT. ELVO screen may be considered a useful marker for screening LVO in prehospital settings in terms of the sensitivity and negative predictive value; however, further improvement may be necessary to reduce the rate of false positive results.

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Section: Discussionmentioning

confidence: 99%

Clinical Impact of a Local Triage System Using the Emergent Large Vessel Occlusion Screen with a Rotation System of Thrombectomy-Capable Hospitals

Takahashi,

Ono,

Moroi

et al. 2024

JNET

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“…Moreover, the modified Gaze-Face-Arm-Speech-Time scale has been tested with 150 consecutive patients; findings indicate improvements in dispatch-to-groin puncture time [16]. Finally, the Japan Urgent Stroke Triage scale was studied at 13 centres in Hiroshima, Japan, as a tool for detecting LVO patients for direct transfer.…”

Section: Use Of Prehospital Scales As a Strategy For Triage Of Strokementioning

confidence: 99%

Prehospital stroke management and mobile stroke units

Faßbender

Lesmeister

Merzou

2023

Current Opinion in Neurology

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Purpose of reviewDelayed presentation at the hospital contributes to poorer patient outcomes and undertreatment of acute stroke patients. This review will discuss recent developments in prehospital stroke management and mobile stroke units aimed to improve timely access to treatment within the past 2 years and will point towards future directions.Recent findingsRecent progress in research into prehospital stroke management and mobile stroke units ranges from interventions aimed at improving patients’ help-seeking behaviour, to the education of emergency medical services team members, to the use of innovative referral methods, such as diagnostic scales, and finally to evidence of improved outcomes by the use of mobile stroke units.SummaryUnderstanding is increasing about the need for optimizing stroke management over the entire stroke rescue chain with the goal of improving access to highly effective time-sensitive treatment. In the future, we can expect that novel digital technologies and artificial intelligence will become relevant in effective interaction between prehospital and in-hospital stroke-treating teams, with beneficial effects on patients’ outcomes.

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mG-FAST, a single pre-hospital stroke screen for evaluating large vessel and non-large vessel strokes

Cited by 2 publications

References 13 publications

Clinical Impact of a Local Triage System Using the Emergent Large Vessel Occlusion Screen with a Rotation System of Thrombectomy-Capable Hospitals

Clinical Impact of a Local Triage System Using the Emergent Large Vessel Occlusion Screen with a Rotation System of Thrombectomy-Capable Hospitals

Prehospital stroke management and mobile stroke units

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