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Cutting the Prehospital On-Scene Time of Stroke Thrombolysis in Helsinki: A Prospective Interventional Study.

Authors :
Puolakka T
Kuisma M
Länkimäki S
Puolakka J
Hallikainen J
Rantanen K
Lindsberg PJ
Source :
Stroke [Stroke] 2016 Dec; Vol. 47 (12), pp. 3038-3040. Date of Electronic Publication: 2016 Nov 08.
Publication Year :
2016

Abstract

Background and Purpose: Significant portion of the prehospital delay consists of minutes spent on the scene with the patient. We implemented a training program for the emergency medical services personnel with the aim to optimize the on-scene time (OST) and to study the impact of different elements of prehospital practice to the OST duration.<br />Methods: In this prospective interventional study, key operational emergency medical service performance variables were analyzed from all thrombolysis candidates transported to the Helsinki University Hospital emergency department. The catchment period was 4 months before and 4 months after the implementation.<br />Results: One hundred and forty-one patients were managed as thrombolysis candidates before and 148 patients after the training program implementation. The OST duration for the groups was 25 (20.5-31) and 22.5 (18-28.5) minutes, respectively (P<0.001). Physician consultations via telephone were associated with a longer (odds ratio 0.546 [0.333-0.893]) and advanced life support training with a shorter OST (odds ration 1.760 [1.070-2.895]).<br />Conclusions: Implementation of the emergency medical services training program successfully decreased the OST of thrombolysis candidates by 10%. Higher expertise level of the ambulance crew was associated with shorter OST, and decisions to consult a physician via telephone were reflected by longer OST.<br /> (© 2016 American Heart Association, Inc.)

Details

Language :
English
ISSN :
1524-4628
Volume :
47
Issue :
12
Database :
MEDLINE
Journal :
Stroke
Publication Type :
Academic Journal
Accession number :
27827326
Full Text :
https://doi.org/10.1161/STROKEAHA.116.014531