Stretcher Angles: Impact on Vital Signs and Optic Nerve Sheath Diameter in Prehospital Stroke Patients

Abstract

Objectives Post-stroke hypoperfusion of brain tissue often results from increased intracranial pressure (ICP), which compromises cerebral blood flow. This study aimed to investigate the relationships between the stretcher angles of stroke patients brought to the emergency department by emergency medical services (EMS) and the optic nerve sheath diameter (ONSD) and vital signs. Methods This was a prospective, cross-sectional, single-center study. The study included individuals over 18 years of age at stroke according to the Cincinnati Stroke Scale. Patient age, sex, time to hospital arrival with an EMS, the ONSD, vital signs, clinical findings, the stretcher angle, and Glasgow Coma Scale (GCS) scores were recorded. Stretcher angles were adjusted to 4 different groups. Group 1, 0–30°; Group 2, 31–45°; Group 3, 46–60°; and Group 4, 61–90°. Results The study included 82 patients, 42.7% of whom were male, and the average age was 74 years. Group 1 had 16 patients (19.5%), Group 2 had 27 patients (32.9%), Group 3 had 22 patients (26.8%), and Group 4 had 17 patients (20.7%). The mean systolic blood pressure (SBP) was 163 ± 35 mmHg, the mean diastolic blood pressure (DBP) was 91 ± 17 mmHg, the mean right ONSD was 0.36 ± 0.07 cm, and the mean left ONSD was 0.37 ± 0.07 cm. The mean GCS of the patients was 13. The GCS was lower in Group 1 than in Group 3 (p = 0.002), the DBP was greater in Group 4 than in Group 3 (0.023), and the ONSD was greater in Group 4 than in Group 2 (p = 0.007). Conclusion The stretcher angle of patients transported by the EMS is related to the patient's GCS, ONSD, and DBP. We recommend that EMS personnel carry stroke patients at 46–60° at a stretcher angle during transport. Prehospital EMS personnel need to pay more attention to the stretcher angle and be informed about it when transporting patients with suspected strokes.