For Immediate Use
March 3, 2000
Roxanne Yamaguchi Moster
([email protected])
(310) 794-0777
NEW STROKE SCREENING TOOL PROVES ACCURATE IN STUDY; HELPS EMERGENCY MEDICAL PERSONNEL QUICKLY DETECT STROKE VICTIMS
A study by the UCLA Stroke Center says that a new tool designed to help emergency medical services personnel accurately detect potential stroke patients in the field has proved 91 percent accurate. The UCLA researchers encourage other U.S. cities to adopt and use this new stroke survey to help save more lives.
The study, published in the January issue of the journal Stroke, tested a one-page exam form designed to enhance the ability of emergency medical technicians and paramedics to rapidly identify acute stroke patients when delivering emergency services in the field.
Despite several years of education and experience since the U.S. Food and Drug Administration approved intravenous tissue plasminogen activator (tPA) as the first effective treatment for acute ischemic stroke, over 98 percent of stroke patients are still not receiving this life-saving therapy. Arriving at the hospital beyond the "window of opportunity" continues to be the leading reason for treatment disqualification, indicating an urgent need to develop methods that decrease delays in transport to the hospital.
Since emergency medical services personnel provide the first medical contact for 35-to-70 percent of all stroke patients, prehospital personnel can reduce delays in treatment by reliable identification of stroke patients, UCLA researchers say.
"The biggest problem we see is that patients don't get to a hospital in time," said UCLA stroke expert Dr. Chelsea Kidwell, a neurologist and the study's lead author. "We can only give the clot-busting drug tPA to a stroke patient after a complete evaluation to determine the patient's eligibility, all under three hours from the stroke's onset. By quickly identifying an acute stroke, a patient's potential for a better outcome greatly increases. With this information, emergency medical services personnel can radio ahead to the receiving hospital allowing rapid mobilization of their stroke team and early access to CAT scanners or other vital diagnostic equipment."
Paramedics from engine companies assigned to transport patients to UCLA Medical Center's three emergency base stations were trained and certified in the use of the Los Angeles Prehospital Stroke Screen. Over seven months, paramedics completed the Los Angeles
Prehospital Stroke Screen survey on almost 1,300 patients, including 206 who had complaints suggestive of a neurological problem.
The survey results were compared with emergency department and hospital discharge diagnoses. Paramedic accuracy in correctly identifying potential stroke patients with the new survey was 91 percent.
"The Los Angeles Prehospital Stroke Screen showed excellent accuracy in identifying stroke patients in the field," said Dr. Jeffrey Saver, director of the UCLA Stroke Center. "The Los Angeles Prehospital Stroke Screen is the first validated stroke identification instrument specifically designed for paramedics and emergency medical technicians."
According to UCLA researchers, prior studies found substantially lower accuracy of emergency medical personnel in identifying stroke when the Los Angeles Prehospital Stroke Screen was not used.
"Widespread use of the Los Angeles Prehospital Stroke Screen would allow more rapid treatment of stroke patients nationally," said Dr. Sidney Starkman, co-director of the UCLA Stroke Center. "We are hoping this will encourage other cities to take advantage of the Los Angeles Prehospital Stroke Screen training package that's been created."
UCLA stroke experts say the next step will involve launching a clinical trial utilizing the Los Angeles Prehospital Stroke Screen form to quickly identify patients in the field, and then to administer neuroprotective drugs immediately in the field to minimize ongoing injury to the brain.
The training package includes an instructional certification video, written materials and the Los Angeles Prehospital Stroke Screen survey. Experts from UCLA, USC and the Los Angeles City Fire Department designed it. For more information, call (310) 794-6379 and ask for the Los Angeles Prehospital Stroke Screen training packet.
In addition to Kidwell, Saver and Starkman, those contributing to the research project were Dr. Marc Eckstein and nurse Kimberly Weems of the USC Emergency Medicine Department, and the Los Angeles City Fire Department.
-UCLA-
RYM094
RSS