VAN Assessment Tool in the Treatment of Acute Ischemic Stroke

Completed

• Conditions: Acute Ischemic Stroke
• Interventions: Other: VAN Stroke Scale

• Registration Number: NCT04951518
• Lead Sponsor: Washington Regional Medical Center

Brief Summary

To investigate the reliability of VAN tool as administered by Emergency Medical Services personnel to predict presence of a large vessel occlusion in setting of cerebral ischemic infarction

Detailed Description

The investigators propose to perform a 6-month pilot study in Northwest Arkansas in collaboration of two EMS providers; Central EMS and AirEvac. These local providers operate in the WRMC catchment area and transport over 90% of patients with a suspected stroke to WRMC comprehensive stroke center. Thus no changes to their standard operations would be implemented. The aim of this pilot study would be to test the accuracy of VAN-screening in the area in patients treated at WRMC - thus only patients who are brought to WRMC as per current protocol would be included in the study.

The investigators would train Central EMS and AirEvac personnel to perform the V.A.N screen, over a 2-month period (estimated June-July 2020) in several sessions at the Central EMS training center at 800 S. School Ave. in Fayetteville. This training would be performed by study investigators, assisted by medical students, residents, and advanced practice nurses (APNs). The training would consist of a training video, hands-on instruction, and sample scenarios.The investigators would survey all training participants to gather feedback on the format, delivery, and understanding of the training material. The PowerPoint presentation planned for the training session, as well as the post-training quiz, are attached as Appendices to this application. The investigators would expect a rate of 80% correct answers in the post-training quiz. All questions and scenarios would be discussed with all trainees after the quiz, and re-takes would be allowed.

Study Timeline

• Study Start: 2020-10-22
• Study First Submitted: 2021-06-28
• Study First Submitted QC: 2021-06-28
• Study First Posted: 2021-07-06
• Primary Completion: 2021-12-31
• Study Completion: 2022-03-17
• Status Verified: 2022-04
• Last Update Submitted: 2022-04-26
• Last Update Posted: 2022-04-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

• Patients treated for stroke at WRMC who are transported to the hospital by Central EMS or AirEvac

Exclusion Criteria

• Stroke patients who arrive directly to the hospital (without the use of EMS services)

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Van Negative	VAN Stroke Scale	Large Vessel Occlusion Negative
Van Positive	VAN Stroke Scale	Large Vessel Occlusion Positive

Primary Outcome Measures

Name	Time	Method
Reliability of VAN Assessment Tool	1 Year	To investigate the reliability of VAN tool as administered by Emergency Medical Services personnel to predict presence of a large vessel occlusion in setting of cerebral ischemic infarction

Secondary Outcome Measures

Name	Time	Method
Door to Intervention Time	1 Year	To investigate the effect of prehospital notification of VAN positive status vs routine notification on time door to needle or door to thrombectomy time
Eligibility for Thrombectomy	1 Year	To investigate effect of the VAN tool to predict persons eligible for thrombectomy
Eligibility for Thrombolysis	1 Year	To investigate effect of the VAN tool to predict persons eligible for thrombolysis
Modified Rankin Score	1 Year	To compare the discharge disposition and Rankin score of patients post intervention with VAN prenotification vs routine notification. Rankin scores ranging from 0 - 5, with 0 being fully functioning and independent, and 5 being severe disability requiring constant nursing care.

Trial Locations

Locations (1)

Washington Regional Medical Center; 🇺🇸 Fayetteville, Arkansas, United States