Paramedic identification of stroke : community validation of the Melbourne ambulance stroke screen

Bray, Janet E., Martin, Jenepher, Cooper, Greg, Barger, Bill, Bernard, Stephen and Bladin, Christopher 2005, Paramedic identification of stroke : community validation of the Melbourne ambulance stroke screen, Cerebrovascular diseases, vol. 20, no. 1, pp. 28-33.

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Title Paramedic identification of stroke : community validation of the Melbourne ambulance stroke screen
Author(s) Bray, Janet E.
Martin, Jenepher
Cooper, Greg
Barger, Bill
Bernard, Stephen
Bladin, Christopher
Journal name Cerebrovascular diseases
Volume number 20
Issue number 1
Start page 28
End page 33
Publisher S. Karger AG
Place of publication Basel, Switzerland
Publication date 2005-01
ISSN 1015-9770
1421-9786
Keyword(s) ambulance
stroke diagnosis
emergency medical services
stroke assessment tool
management of acute stroke
Summary Background: Paramedics require an effective prehospital tool to eliminate stroke mimics and to assist in the identification of suitable candidates for thrombolytic therapy. The Faster Access to Stroke Therapies study combined two validated stroke assessment tools (the Los Angeles Prehospital Stroke Screen, LAPSS, and the Cincinnati Prehospital Stroke Scale, CPSS) to form the Melbourne Ambulance Stroke Screen (MASS), and performed an in-field validation by Australian paramedics.

Methods
: Over a 12-month period, 18 paramedics participated in the Faster Access to Stroke Therapies study and prospectively collected data contained in the MASS on all stroke dispatches, and for other patients with a focal neurological deficit. Sensitivity and specificity analysis of the LAPSS, CPSS and MASS was calculated and equivalence analysis performed.

Results
: Paramedics completed 100 MASS assessments for 73 (73%) stroke/transient ischemic attack patients and 27 (27%) stroke mimics. The sensitivity of the MASS (90%, 95% CI: 81-96%) showed statistical equivalence to the sensitivity of the CPSS (95%, p = 0.45) and superiority to the LAPSS (78%, p = 0.008). The specificity of the MASS (74%, 95% CI: 53-88%) was equivalent to that of the LAPSS (85%, p = 0.25) and superior to the CPSS (54%, p = 0.007). All patients misidentified by the MASS (7 strokes, 7 mimics) were ineligible for thrombolytic therapy.

Conclusion
: The MASS is simple to use, with accurate prehospital identification of stroke. It distinguishes stroke mimics, with good recognition of suitable patients for thrombolytic therapy.
Language eng
Field of Research 111099 Nursing not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2005, S. Karger AG
Persistent URL http://hdl.handle.net/10536/DRO/DU:30022495

Document type: Journal Article
Collection: School of Nursing and Midwifery
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