An interventional study to improve paramedic diagnosis of stroke

Bray, Janet E., Martin, Jenepher, Cooper, Greg, Barger, Bill, Bernard, Stephen and Bladin, Christopher 2005, An interventional study to improve paramedic diagnosis of stroke, Prehospital emergency care, vol. 9, no. 3, pp. 297-302, doi: 10.1080/10903120590962382.

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Title An interventional study to improve paramedic diagnosis of stroke
Author(s) Bray, Janet E.
Martin, Jenepher
Cooper, Greg
Barger, Bill
Bernard, Stephen
Bladin, Christopher
Journal name Prehospital emergency care
Volume number 9
Issue number 3
Start page 297
End page 302
Publisher Informa Healthcare
Place of publication London, England
Publication date 2005
ISSN 1090-3127
Summary Objective: The aim of the Faster Access to Stroke Therapy (FAST) study was to determine the effect of educational intervention andthe use of a prehospital stroke tool on the paramedic diagnosis of stroke.

Methods: Paramedics in emergency medical service units servicing a university teaching hospital were divided into two groups: FAST study paramedics (n = 18) and non-FAST study paramedics (n = 43). The FAST study paramedics received stroke education and instruction in the use of a prehospital stroke assessment tool [Melbourne Ambulance Stroke Screen (MASS)] to assist in stroke diagnosis. Based on final hospital diagnosis, the sensitivities of paramedic stroke diagnosis in the two groups were compared for a 12-month period before andafter the intervention.

Results: The sensitivity for the FAST study paramedics in identifying stroke improved from 78% (95% confidence interval [CI]: 63% to 88%) to 94% (95% CI: 86% to 98%) (p = 0.006) after receiving the stroke education session and with use of the MASS tool. There was no change in stroke diagnosis for the non-study paramedics 78% (95% CI: 71% to 84%) to 80% (95% CI: 72% to 87%) (p = 0.695). Prenotification of impending arrival to the emergency department was associated with higher-priority triage in the emergency department, and subsequent shorter times for door to medical review (15 min vs. 31 min, p < 0.001) and door to computed tomography (CT) scanning (94 min vs. 144 min, p < 0.001).

Conclusions: Targeted stroke education and the use of a simple clinical tool can significantly improve the diagnostic sensitivity of stroke by paramedics in the prehospital setting. Accurate diagnosis combined with prenotification of the pending arrival of stroke patients will allow for the focused and timely application of resources for the management of acute stroke.
Language eng
DOI 10.1080/10903120590962382
Field of Research 111099 Nursing not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
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Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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