Evaluation of pre-hospital transport time of stroke patients to thrombolytic treatment

Abstract

BackgroundEffective treatment of stroke is time dependent. Pre-hospital management is an important link in reducing the time from occurrence of stroke symptoms to effective treatment. The aim of this study was to evaluate time used by emergency medical services (EMS) for stroke patients during a five-year period in order to identify potential delays and evaluate the reorganization of EMS in Copenhagen in 2009.MethodsWe performed a retrospective analysis of ambulance records from stroke patients suitable for thrombolysis from 1 January 2006 to 7 July 2011. We noted response time from dispatch of the ambulance to arrival at the scene, on-scene time and transport time to the hospital—in total, alarm-to-door time. In addition, we noted baseline characteristics.ResultsWe reviewed 481 records (58% male, median age 66 years). The median (IQR) alarm-to-door time in minutes was 41 (33–52), of which 18 (12–24) minutes were spent on scene. Response time was reduced from the period before to the period after reorganization (7 vs. 5 minutes, p <0.001). In a linear multiple regression model, higher patient age and longer distance to the hospital correlated with significantly longer transportation time (p <0.001).ConclusionsThis study shows an unchanged alarm-to-door time of 41 minutes over a five-year period. Response time, but not total alarm-to-door time, was reduced during the five years. On-scene time constituted nearly half of the total alarm-to-door time and is thus a point of focus for improvement.

Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria: A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions

“…In addition, the writing committee further endorses the establishment of clear algorithms and care paths for identifying and managing stroke patients eligible for interventions via catheter-based treatment modalities (fig. 5) [61]. All medical staff, including physicians, nursing, and ancillary staff, must be educated in such protocols, and a system must be established where alert system may be activated easily and rapidly.…”

Stroke and the emergency medical services – enhancing performance within the chain of survival

“…Although OSTs as low as 15 to 18 minutes have been successfully achieved by both American and Danish investigators (Patel et al 2014, Simonsen et al 2014, those reports did not discuss the duration of in-hospital delays nor the OTT. Caution is required when comparing and interpreting the results from different EMS systems since an excessively tight time limit for the OST might result in inferior quality of patient examination and reporting.…”

“…intravenous cannula placement) and the neurologist consultation during ambulance transport (Simonsen et al 2014). However, travel time to the hospital period in highly dependable EMS systems (Tables 10,15,17 & 19).…”

Factors Affecting the Location of Road Emergency Bases in Iran Using Analytical Hierarchy Process (AHP)

“…Response time is a very important factor in increasing the chance of patients' survival and decreasing the side effects caused by the accidents [7,8]. In Iran, traffic accidents are the main cause of injuries and the second cause of deaths after cardiovascular diseases [2,9,10], and its prevalence is four times more than that in the developed countries [11].…”