Diagnostic Accuracy of Stroke Referrals From Primary Care, Emergency Room Physicians, and Ambulance Staff Using the Face Arm Speech Test

Harbison, J.; Hossain, Omar; Jenkinson, Damian; Davis, J. G.; Louw, Stephen; Ford, Gary A.

doi:10.1161/01.str.0000044170.46643.5e

Cited by 440 publications

(361 citation statements)

References 23 publications

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“…Frequent misdiagnosis of stroke has been described among non-neurologist medical providers 23 . The presence of a neurologist in the emergency room has been proposed as a solution to improve this situation 24 .…”

Section: Discussionmentioning

confidence: 99%

Perception of stroke symptoms and utilization of emergency medical services

Hawkes

Farez

Calandri

et al. 2016

Arq. Neuro-Psiquiatr.

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Lack of stroke awareness and slow activation of emergency medical services (EMS) are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75%) arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02). Nineteen patients (20%) were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001). Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

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Section: Discussionmentioning

confidence: 99%

Perception of stroke symptoms and utilization of emergency medical services

Hawkes

Farez

Calandri

et al. 2016

Arq. Neuro-Psiquiatr.

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“…(f) Stroke: Early recognition of stroke using stroke assessment systems can decrease the time interval between onset and arrival at hospital for defi nitive treatment, leading to improved functional outcomes. (38)(39)(40)(41)(42)(43) First aid providers should be trained in the use of stroke assessment systems to recognise the signs and symptoms of stroke. We recommend the use of the FAST (Face, Arm, Speech, Time) stroke assessment system, which is the simplest tool for bystanders, with high sensitivity for the identifi cation of stroke.…”

Section: Medicalmentioning

confidence: 99%

Guidelines for Bystander First Aid 2016

Pek¹

2017

smedj

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Cardiac life support is a form of fi rst aid for cardiac emergencies. However, research and evidence in this fi eld is lacking compared with other forms of fi rst aid. Having identifi ed the common emergencies that are encountered in the hospital, based on the available evidence, we have put together what could be an evidence-based approach to the fi rst aid management of some of these common emergencies, viz. breathlessness, chest pain, allergies, stroke, heat injury, poisoning, unconsciousness, seizures, and trauma situations such as bleeding, wounds, contusions, head injury, burns and fractures. Educating the public is the key to developing a fi rst responder bystander. These guidelines could become the basis for training of the public.

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“…Consequentially, EMTs and paramedics have been able to perform better in stroke recognition than the EMD (up to 90% of cases) but the results have varied widely depending on the EMS system in question. After the development of dedicated prehospital stroke scales such as the CPSS , FAST (Harbison et al 2003) and the Los Angeles Prehospital Stroke Screen (LAPSS) (Kidwell et al 2000) In general, FAST and CPSS have been reported to have higher sensitivity than LAPSS while LAPSS clinical items whereas the LAPSS is longer and consists of an interview and clinical section. However, the overall performance of the three major stroke scales has been similar in comparative studies (Tables 6 & 7).…”

Section: Prehospital Recognition Of Acute Strokementioning

confidence: 99%