Prehospital Phase of the Stroke Chain of Survival : A Prospective Observational Study

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Puolakka , T , Strbian , D , Harve , H , Kuisma , M & Lindsberg , P J 2016 , ' Prehospital Phase of the Stroke Chain of Survival : A Prospective Observational Study ' , Journal of the American Heart Association , vol. 5 , no. 5 , 002808 .

Title: Prehospital Phase of the Stroke Chain of Survival : A Prospective Observational Study
Author: Puolakka, Tuukka; Strbian, Daniel; Harve, Heini; Kuisma, Markku; Lindsberg, Perttu J.
Contributor: University of Helsinki, Neurologian yksikkö
University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2016-05
Language: eng
Number of pages: 8
Belongs to series: Journal of the American Heart Association
ISSN: 2047-9980
Abstract: Background-Few studies have discussed the emergency call and prehospital care as a continuous process to decrease the prehospital and in-hospital delays for acute stroke. To identify features associated with early hospital arrival ( Methods and Results-This was a 2-year prospective observational study. All stroke patients who were transported to the hospital by emergency medical services and received recanalization therapy were recruited for the study. For a sample of 308 patients, the stroke code was activated in 206 (67%) and high priority was used in 258 (84%) of the emergency calls. Emergency medical services transported 285 (93%) of the patients using the stroke code and 269 (87%) using high priority. In the univariate analysis, the most dominant predictors of early hospital arrival were transport using stroke code (P= 0.001) and high priority (P= 0.002) and onset-to-call (P<0.0001) and on-scene times (P= 0.052). In the regression analysis, the influences of high-priority transport (P<0.01) and onset-to-call time (P<0.001) prevailed as significant in both dichotomies of early arrival and treatment. The on-scene time was found to be surprisingly long (> 23.5 minutes) for both early and late-arriving patients. Conclusions-Fast emergency medical services activation and ambulance transport promoted early hospital arrival and treatment. Although patient-dependent delays still dominate the prehospital process, it should be ensured that the minutes on the scene are well spent.
Subject: emergency medical services
time factors
3121 General medicine, internal medicine and other clinical medicine
3112 Neurosciences
3124 Neurology and psychiatry

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