Accuracy and Implementation of Diagnostic Ability in Stroke in the Pre-Hospital Setting
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Agenzia Regionale emergenza Urgenza
- Enrollment
- 2197
- Locations
- 1
- Primary Endpoint
- Accuracy of prehospital stroke diagnosis
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Current American Heart Association Guidelines recommend that stroke patients be promptly rescued and identified so that the accepting hospital can be alerted and prepared to receive and treat them promptly. It is also recommend that stroke identification be performed using validated and standardized assessment scales. This study aims to analyze the possibility to increase the correct identification of stroke patients after implementation of several new operative procedures by the emergency medical service (EMS) of the metropolitan area of Milan (SOREU). The interventions adopted include:
- the evaluation of patients with suspected stroke via video call between the lay rescue personnel and the dispatch healthcare personnel
- the training of lay rescue personnel, operating in the metropolitan area, aimed at implementing the application of the Cincinnati Prehospital Stroke Scale (CPSS) scale and to expand the neurological examination with the addiction of the Large ARtery Intracranial Occlusion Stroke Scale (LARIO) in the clinical evaluation.
Investigators
Eligibility Criteria
Inclusion Criteria
- •suspected stroke
- •rescued by basic life support vehicle
- •consciousness
- •informed consent
Exclusion Criteria
- •age \< 18 years
- •rescued by an advanced life support vehicle
Outcomes
Primary Outcomes
Accuracy of prehospital stroke diagnosis
Time Frame: within 2 hours from hospital admission
Evaluate if the use of the video call with or without the assessment of the LARIO scale, between the prehospital lay rescuer and the medical dispatch improve the identification of stroke patients in comparison to the only CPSS scale evaluated by the lay rescuer. The diagnosis accuracy is evaluated by confirmation of stroke at the cerebral angio-CT scan
Secondary Outcomes
- Accuracy of the Large ARtery Intracranial Occlusion (LARIO) scale to identify a stroke with occlusion of a large vessels(within 2 hours from hospital admission)
- incidence of hemorrhagic stroke(within 2 hours hospital admission)