Prehospital stroke scale (<scp>FAST PLUS</scp> Test) predicts patients with intracranial large vessel occlusion

Václavík, Daniel; Bar, Michal; Klečka, Lukáš; Holeš, David; Cabal, Martin; Mikulík, Robert

doi:10.1002/brb3.1087

Cited by 36 publications

(55 citation statements)

References 16 publications

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“…The choice between the mother-ship and the dripand-ship models would have been easier if there had been a prehospital test that could accurately identify large artery occlusion. [50][51][52][53][54][55][56] If such a test had been available, it would have changed how we look at this problem since it could have guided the decision to transport the patient to the comprehensive stroke center for intraarterial intervention or to the primary stroke center for intravenous thrombolytic treatment. A trial is on-going on direct transfer to a comprehensive stroke center compared to transfer to the closest stroke center in patients selected with a specific prehospital screening tool to identify large artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of organizational models for intra-arterial treatment of acute ischemic stroke

Ciccone

Berge

Fischer

2018

International Journal of Stroke

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Background: Intra-arterial treatment of acute ischemic stroke requires changes to acute stroke services since most hospitals do not have on-site intra-arterial treatment facilities. Aim: To identify models for delivery of intra-arterial treatment and to compare process performance and clinical and radiological outcomes of the different models. Methods: We systematically searched the literature and contacted experts in the field. We performed a qualitative synthesis to identify models, and a quantitative review and meta-analysis of clinical and radiological outcomes under different organizational models. Summary of review: The searches retrieved 148 publications, of which 27 were used for the identification and description of models, and 9 for the comparison of the different models. We identified four main models: the mother-ship, drip-and ship, mobile interventionist, and mobile stroke unit models. There were no randomized-controlled trials of the different models, but non-randomized comparisons were possible using data from 8 observational studies and 1 randomized-controlled trial of intra-arterial therapy, of a total of 4127 patients. Comparison between the mothership and drip-and-ship models showed no difference in survival (OR 0.81; 95% CI 0.63-1.03), favorable functional outcome (OR 0.96; 95% CI 0.73-1.25), or arterial patency (OR 0.89; 95% CI 0.73-1.08). Conclusions: Different organizational models exist for intra-arterial treatment of acute ischemic stroke, but there is insufficient evidence to recommend a particular, universal model. Until one model can be shown to be superior, the choice of model should depend on local factors and patient characteristics.

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Section: Discussionmentioning

confidence: 99%

Systematic review of organizational models for intra-arterial treatment of acute ischemic stroke

Ciccone

Berge

Fischer

2018

International Journal of Stroke

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“…Some studies suggest that the use of e-learning material enhanced both neurological assessment by nurses and quality of care in stroke teams [ 29 , 30 ]. Different e-learning tools aiming to improve symptoms recognition and global care of stroke patients are currently being developed and implemented [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

et al. 2020

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Background Prompt and accurate identification of stroke victims is essential to reduce time from symptom onset to adequate treatment and to improve neurological outcomes. Most neurologists evaluate the extent of neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS), but the use of this scale by paramedics, the first healthcare providers to usually take care of stroke victims, has proven unreliable. This might be, at least in part, due to the teaching method. The video used to teach NIHSS lacks interactivity, while more engaging electronic learning (e-learning) methods might improve knowledge acquisition. Objective This study was designed to evaluate whether a highly interactive e-learning module could enhance NIHSS knowledge acquisition in paramedics. Methods A randomized controlled trial comparing a specially designed e-learning module with the original NIHSS video was performed with paramedics working in Geneva, Switzerland. A registration number was not required as our study does not come into the scope of the Swiss federal law on human research. The protocol was nevertheless submitted to the local ethics committee (Project ID 2017-00847), which issued a “Declaration of no objection.” Paramedics were excluded if they had prior knowledge of or previous training in the NIHSS, or if they had worked in a neurology or neurosurgery ward. The primary outcome was overall performance in the study quiz, which contained 50 questions. Secondary outcomes were performance by NIHSS item, time to course and quiz completion, user satisfaction regarding the learning method, user perception of the course duration, and probability the user would recommend the course to a colleague. Results The study was completed by 39 paramedics. There was a better overall median score (36/50 vs 33/50, P=.04) and a higher degree of satisfaction regarding the learning method in the e-learning group (90% vs 37%, P=.002). Users who had followed the e-learning module were more likely to recommend the course to a colleague (95% vs 63%, P=.02). Paramedics in the e-learning group took more time to complete the course (93 vs 59 minutes, P<.001), but considered the duration to be more adequate (75% vs 32%, P=.01). Time to quiz completion was similar between groups (25 vs 38 minutes, P=.12). Conclusions Use of an e-learning module shows promising results in teaching the NIHSS to paramedics.

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“…It stands for Facial palsy, any failure of Arm or Speech function and time (to call for help). A stroke is recognized, if at least one of those symptoms occurs [17]. The National Institutes of Health Stroke Scale (NIHSS) is mainly used with acute ischemic stroke [18].…”

Section: Classification and Diagnosismentioning

confidence: 99%

New directions in treatment of the ischemic stroke

Zaremba

Gorecka

Wysokińska

et al. 2020

J Educ Health Sport

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Stroke remains a leading cause of death and disability worldwide. The cause is decrease or total blocking of blood perfusion in brain and fast recognition is essential to conduct proper treatment. Currently commonly used methods are thrombolysis and mechanical thrombectomy, which high efficacy is observed only if they are performed within a few hours of the first symptoms. Hence loads of people, who are diagnosed later, become unable to undergo effective treatment. In the study are presented pathogenesis, epidemiology, classification, diagnosis and current treatment of the disease, but the main aim of the study is to present the results of the reports on new treatments for ischemic stroke. The research method is a review of the available literature published in PubMed, UpToDate and Google scholar databases. In the study were reviewed new methods, which can be alternative for currently used ones. They are small molecules including fluoxetine, aripiprazole, L-DOPA, cholinergic and 67 noradrenergic drugs, growth factors (HCG, EPO), monoclonal antibodies, allogenic stem cells, neurostimulators, robotic therapy and telerehabilitation. They give hope for curing a larger number of patients and improving effects of rehabilitation after ischemic stroke. However most of the methods, which are presented in this study require the use of tests that will allow checking their safety and application.

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Prehospital stroke scale (FAST PLUS Test) predicts patients with intracranial large vessel occlusion

Cited by 36 publications

References 16 publications

Systematic review of organizational models for intra-arterial treatment of acute ischemic stroke

Systematic review of organizational models for intra-arterial treatment of acute ischemic stroke

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

New directions in treatment of the ischemic stroke

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