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Chapter 3 - Prehospital Stroke Care and Regionalized Stroke Systems

from Part II - Systems of Care

Published online by Cambridge University Press:  15 December 2020

By
Kori Sauser Zachrison  and
Lee H. Schwamm
Edited by
Jeffrey L. Saver  and
Graeme J. Hankey
Jeffrey L. Saver
Affiliation:
David Geffen School of Medicine, University of Ca
Graeme J. Hankey
Affiliation:
University of Western Australia, Perth
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Summary

Prehospital stroke care is the first link in the stroke chain of survival and includes symptom recognition, engagement of the Emergency Medical Services (EMS) system, timely and effective dispatcher response, and emergency medical response. Prehospital stroke screening tools are an important component in guiding the EMS response to stroke and proper triage of patients. Additionally, there is a growing body of research focused on applications for telemedicine, mobile stroke units, and diagnostic testing in the prehospital arena. Prehospital stroke care is integral to the organization of regionalized stroke systems. Implementation of stroke systems of care can lead to improved access to specialty services and improved patient health outcomes. In addition to increasing access to acute stroke care, telestroke shows great potential for integrating stroke systems of care and facilitating interactions between centres.

Keywords

Prehospitalambulanceparamedicdispatcherischaemic strokeintracerebral haemorrhagesubarachnoid haemorrhageroutingemergency medical systemstroke centres
Type
Chapter
Information
Stroke Prevention and Treatment
An Evidence-based Approach
 , pp. 35 - 58
Publisher: Cambridge University Press
Print publication year: 2020

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References

Abdullah, AR, Smith, EE, Biddinger, PD, Kalenderian, D, Schwamm, LH. (2008). Advance hospital notification by EMS in acute stroke is associated with shorter door-to-computed tomography time and increased likelihood of administration of tissue-plasminogen activator. Prehospital Emerg Care, 12, 426–31. doi:10.1080/10903120802290828.Google Scholar
Acker, JE 3rd, Pancioli, AM, Crocco, TJ, Eckstein, MK, Jauch, EC, Larrabee, H, et al. (2007). Implementation strategies for emergency medical services within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association Expert Panel on Emergency Medical Services Systems and the Stroke Council. Stroke, 38, 3097–115. doi:10.1161/STROKEAHA.107.186094.Google Scholar
Adams, J, Aldag, G, Wolford, R. (1996). Does the level of prehospital care influence the outcome of patients with altered levels of consciousness? Prehospital Disaster Med, 11, 101–4.Google Scholar
Adeoye, O, Albright, KC, Carr, BG, Wolff, C, Mullen, MT, Abruzzo, L, et al. (2014). Geographic access to acute stroke care in the United States. Stroke, 45, 3019–24. doi:10.1161/STROKEAHA.114.006293.Google Scholar
Adeoye, O, Hornung, R, Khatri, P, Kleindorfer, D. (2011). Recombinant tissue-type plasminogen activator use for ischemic stroke in the United States: a doubling of treatment rates over the course of 5 years. Stroke, 42,1952–5. doi:10.1161/STROKEAHA.110.612358.Google Scholar
Alexander, P, Heels-Ansdell, D, Siemieniuk, R. (2016). Hemicraniectomy versus medical treatment with large MCA infarct: a review and meta-analysis. BMJ Open, 6, e014390. doi:10.1136/bmjopen-2016-014390.Google Scholar
Ali, A, Zachrison, KS, Eschenfeldt, PC, Schwamm, LH, Hur, C. (2018). Optimization of prehospital triage of patients with suspected ischemic stroke. Stroke, 49, 2532–5. doi:10.1161/STROKEAHA.118.022041.CrossRefGoogle ScholarPubMed
Amadi-Obi, A, Gilligan, P, Owens, N, O’Donnell, C. (2014). Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment. Int J Emerg Med, 7, 29. doi:10.1186/s12245-014-0029-0.Google Scholar
Anderson, ER, Smith, B, Ido, M, Frankel, M. (2013). Remote assessment of stroke using the iPhone 4. J Stroke Cerebrovasc Dis, 22, 340–4. doi:10.1016/j.jstrokecerebrovasdis.2011.09.013.Google Scholar
Ankolekar, S, Fuller, M, Cross, I, Renton, C, Cox, P, Sprigg, N, et al. (2013). Feasibility of an ambulance-based stroke trial, and safety of glyceryl trinitrate in ultra-acute stroke: the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial (RIGHT, ISRCTN66434824). Stroke, 44, 3120–8. doi:10.1161/STROKEAHA.113.001301.Google Scholar
Audebert, HJ, Kukla, C, Vatankhah, B, Gotzler, B, Schenkel, J, Hofer, S, et al. (2006). Comparison of tissue plasminogen activator administration management between telestroke network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany. Stroke, 37, 1822–7. doi:10.1161/01.STR.0000226741.20629.b2.Google Scholar
Bae, H-J, Kim, D-H, Yoo, N-T, et al. (2010). Prehospital notification from the emergency medical service reduces the transfer and intra-hospital processing times for acute stroke patients. J Clin Neurol, 6, 138. doi:10.3988/jcn.2010.6.3.138.CrossRefGoogle ScholarPubMed
Bardach, NS, Olson, SJ, Elkins, JS, Smith, WS, Lawton, MT, Johnston, SC, et al. (2004). Regionalization of treatment for subarachnoid hemorrhage a cost-utility analysis. Circulation, 109, 2207–12. doi:10.1161/01.CIR.0000126433.12527.E6.CrossRefGoogle ScholarPubMed
Berkowitz, AL, Mittal, MK, McLane, HC, Shen, GC, Muralidharan, R, Lyons, JL, et al. (2014). Worldwide reported use of IV tissue plasminogen activator for acute ischemic stroke. Int J Stroke, 9, 349–55. doi:10.1111/ijs.12205.CrossRefGoogle ScholarPubMed
Boogaarts, HD, van Amerongen, MJ, de Vries, J, Westert, GP, Veerbeek, AL, Grotenhuis, JA, et al. (2014). Caseload as a factor for outcome in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Neurosurg, 120, 605–11. doi:10.3171/2013.9.JNS13640.Google Scholar
Bowry, R, Parker, SA, Yamal, JM, Hwang, H, Appana, S, Rangel-Gutierrez, N, et al. (2018). Time to decision and treatment with tPA (tissue-type plasminogen activator) using telemedicine versus an onboard neurologist on a mobile stroke unit. Stroke, 49, 1528–30. doi:10.1161/STROKEAHA.117.020585.CrossRefGoogle ScholarPubMed
Brandler, ES, Sharma, M, Sinert, RH, Levine, SR. (2014). Prehospital stroke scales in urban environments: a systematic review. Neurology, 82, 2241–9. doi:10.1212/WNL.0000000000000523.Google Scholar
Brown, DL, Barsan, WG, Lisabeth, LD, Gallery, ME, Morgenstern, LB. (2005). Survey of emergency physicians about recombinant tissue plasminogen activator for acute ischemic stroke. Ann Emerg Med, 46, 56–60. doi:10.1016/j.annemergmed.2004.12.025.CrossRefGoogle ScholarPubMed
Buck, BH, Starkman, S, Eckstein, M, Kidwell, CS, Haines, J, Huang, R, et al. (2009). Dispatcher recognition of stroke using the National Academy Medical Priority Dispatch System. Stroke, 40(6), 2027–30. doi:10.1161/STROKEAHA.108.545574.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC). (2007). Prehospital and hospital delays after stroke onset – United States, 2005–2006. MMWR Morb Mortal Wkly Rep, 56, 474–8.Google Scholar
Chapman Smith, SN, Govindarajan, P, Padrick, MM, Lippman, JM, McMurry, TL, Resler, BL, et al.; as the iTREAT Investigators. (2016). A low-cost, tablet-based option for prehospital neurologic assessment: The iTREAT Study. Neurology, 87(1), 19–26. doi:10.1212/WNL.0000000000002799.Google Scholar
Chiti, A, Fanucchi, S, Sonnoli, C, Barni, S, Orlandi, G. (2007). Stroke symptoms and the decision to call for an ambulance: turn on people’s minds! Stroke J Cereb Circ, 38, e58–59. doi:10.1161/STROKEAHA.107.489179.Google Scholar
Choi, JY, Porche, NA, Albright, KC, Khaja, AM, Ho, VS, Grotta, JC. (2006). Using telemedicine to facilitate thrombolytic therapy for patients with acute stroke. Jt Comm J Qual Patient Saf, 32, 199–205.Google Scholar
Demaerschalk, BM, Berg, J, Chong, BW, Gross, H, Nystrom, K, Adeoye, O, et al. (2017). American Telemedicine Association: telestroke guidelines. Telemed J E Health, 23, 376–89. doi:10.1089/tmj.2017.0006.Google Scholar
Demaerschalk, BM, Vegunta, S, Vargas, BB, Wu, Q, Channer, DD, Hentz, JG. (2012). Reliability of real-time video smartphone for assessing National Institutes of Health Stroke Scale scores in acute stroke patients. Stroke J Cereb Circ, 43, 3271–7. doi:10.1161/STROKEAHA.112.669150.Google Scholar
Ebinger, M, Kunz, A, Wendt, M, Rozanski, M, Winter, B, Waldschmidt, C, et al. (2015). Effects of golden hour thrombolysis: a Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) Substudy. JAMA Neurol, 72, 25–30. doi:10.1001/jamaneurol.2014.3188.CrossRefGoogle ScholarPubMed
Ebinger, M, Winter, B, Wendt, M, Weber, JE, Waldschmidt, C, Rozanski, M, et al. (2014). Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial. JAMA, 311, 1622–31. doi:10.1001/jama.2014.2850.CrossRefGoogle ScholarPubMed
Ekundayo, OJ, Saver, JL, Fonarow, GC, Schwamm, LH, Xian, Y, Zhao, X, et al. (2013). Patterns of emergency medical services use and its association with timely stroke treatment: findings from Get with the Guidelines-Stroke. Circ Cardiovasc Qual Outcomes, 6, 262–9. doi:10.1161/CIRCOUTCOMES.113.000089.Google Scholar
Evenson, KR, Foraker, RE, Morris, DL, Rosamond, WD. (2009). A comprehensive review of prehospital and in-hospital delay times in acute stroke care. Int J Stroke, 4, 187–99. doi:10.1111/j.1747-4949.2009.00276.x.Google Scholar
Falk Delgado, A, Andersson, T, Falk Delgado, A. (2017). Clinical outcome after surgical clipping or endovascular coiling for cerebral aneurysms: a pragmatic meta-analysis of randomized and non-randomized trials with short- and long-term follow-up. J Neurointerv Surg, 9, 264–77. doi:10.1136/neurintsurg-2016-012292.Google Scholar
Fassbender, K, Grotta, JC, Walter, S, Grunwald, IQ, Ragoschke-Schumm, A, Saver, JL. (2017). Mobile stroke units for prehospital thrombolysis, triage, and beyond: benefits and challenges. Lancet Neurol, 16, 227–37. doi:10.1016/S1474-4422(17)30008-X.Google Scholar
Fletcher, JJ, Kotagal, V, Mammoser, A, Peterson, M, Morgenstern, LB, Burke, JF, et al. (2015). Cost-effectiveness of transfers to centers with neurological intensive care units after intracerebral hemorrhage. Stroke, 46, 58–64. doi:10.1161/STROKEAHA.114.006653.Google Scholar
Fonarow, GC, Liang, L, Smith, EE, Reeves, MJ, Saver, JL, Xian, Y, et al (2013). Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care. J Am Heart Assoc, 2, e000451. doi:10.1161/JAHA.113.000451.Google Scholar
Froehler, MT, Saver, JL, Zaidat, OO, Jahan, R, Aziz-Sultan, MA, Klucznik, RP, et al. (2017). Interhospital transfer before thrombectomy is associated with delayed treatment and worse outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke). Circulation, 136, 2311–21. doi:10.1161/CIRCULATIONAHA.117.028920.Google Scholar
Gadhia, R, Schwamm, LH, Viswanathan, A, Whitney, C, Moreno, A, Zachrison, KS. (2018). Evaluation of the experience of spoke hospitals in an academic telestroke network. Telemed J E Health, 25. doi:10.1089/tmj.2018.0133. [Epub ahead of print]Google Scholar
Goyal, M, Menon, BK, van Zwam, WH, Dippel, DW, Mitchell, PG, Demchuk, AM, et al. (2016). Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet, 387, 1723–31. doi:10.1016/S0140-6736(16)00163-X.CrossRefGoogle ScholarPubMed
Gropen, TI, Boehme, A, Martin-Schild, S, Albright, K, Samai, A, Pishanidar, S, et al. (2018). Derivation and validation of the emergency medical stroke assessment and comparison of large vessel occlusion scales. J Stroke Cerebrovasc Dis, 27, 806–15. doi:10.1016/j.jstrokecerebrovasdis.2017.10.018.CrossRefGoogle ScholarPubMed
Gupta, R, Manuel, M, Owada, K, Dhungana, S, Busby, L, Glenn, BA, et al. (2016). Severe hemiparesis as a prehospital tool to triage stroke severity: a pilot study to assess diagnostic accuracy and treatment times. J Neurointerv Surg, 8, 775–7. doi:10.1136/neurintsurg-2015-011940.Google Scholar
Hawk, A, Marco, C, Huang, M2, Chow, B. (2016). Helicopter scene response for stroke patients: a 5-year experience. Air Med J, 35, 352–4. doi:10.1016/j.amj.2016.05.007.Google Scholar
Hess, DC, Wang, S, Hamilton, W, Lee, S, Pardue, C, Waller, JL, et al. (2005). REACH: clinical feasibility of a rural telestroke network. Stroke, 36, 2018–2020. doi:10.1161/01.STR.0000177534.02969.e4Google Scholar
Hesselfeldt, R, Gyllenborg, J, Steinmetz, J, Do, HQ, Hejselbaek, J, Rasmussen, LS. (2014). Is air transport of stroke patients faster than ground transport? A prospective controlled observational study. Emerg Med J, 31, 268–72. doi:10.1136/emermed-2012-202270.CrossRefGoogle ScholarPubMed
Hidlay, DT, McTaggart, RA, Baird, G, Yaghi, S, Hemendinger, M, Tung, EL, et al. (2018). Accuracy of smartphone-based evaluation of emergent large vessel occlusion on CTA. Clin Neurol Neurosurg, 171, 135–8. doi:10.1016/j.clineuro.2018.06.012.CrossRefGoogle ScholarPubMed
Higashida, R, Alberts, MJ, Alexander, DN, Crocco, TJ, Demaerschalk, BM, Derdeyn, CP, et al. (2013). Interactions within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association. Stroke, 44, 2961–2984. doi:10.1161/STR.0b013e3182a6d2b2.Google Scholar
Hodgson, C, Lindsay, P, Rubini, F. (2007). Can mass media influence emergency department visits for stroke? Stroke J Cereb Circ, 38, 2115–22. doi:10.1161/STROKEAHA.107.484071.Google Scholar
Hodgson, C, Lindsay, P, Rubini, F. (2009). Using paid mass media to teach the warning signs of stroke: the long and the short of it. Health Promot J Aust Off J Aust Assoc Health Promot Prof, 20, 58–64.Google Scholar
Holodinsky, JK, Williamson, TS, Demchuk, AM, Zhao, H, Zhu, L, Francis, MJ, et al. (2018). Modeling stroke patient transport for all patients with suspected large-vessel occlusion. JAMA Neurol, 75, 1477–86. doi:10.1001/jamaneurol.2018.2424.Google Scholar
Hougaard, KD, Hjort, N, Zeidler, D, Sørensen, L, Nørgaard, A, Hansen, TM, et al. (2014). Remote ischemic preconditioning as an adjunct therapy to thrombolysis in patients with acute ischemic stroke: a randomized trial. Stroke, 45, 159–67. doi:10.1161/STROKEAHA.113.001346.Google Scholar
Hunter, RM, Davie, C, Rudd, A, Thompson, A, Walker, H, Thomson, N, et al. (2013). Impact on clinical and cost outcomes of a centralized approach to acute stroke care in London: a comparative effectiveness before and after model. PloS One, 8, e70420. doi:10.1371/journal.pone.0070420.CrossRefGoogle Scholar
Hutton, CF, Fleming, J, Youngquist, S, Hutton, KC, Heiser, DM, Barton, ED. (2015). Stroke and helicopter emergency medical service transports: an analysis of 25,332 patients. Air Med J, 34, 348–56. doi:10.1016/j.amj.2015.06.011.Google Scholar
Johnston, KC, Worrall, BB. (2003). Teleradiology Assessment of Computerized Tomographs Online Reliability Study (TRACTORS) for acute stroke evaluation. Telemed J E Health, 9, 227–233. doi:10.1089/153056203322502605.Google Scholar
John, S, Stock, S, Masaryk, T, Bauer, A, Cerejo, R, Uchino, K, et al. (2016). Performance of CT angiography on a mobile stroke treatment unit: implications for triage. J Neuroimaging, 26(4), 391–4. doi:10.1111/jon.12346.Google Scholar
Joo, H, Wang, G, George, MG. (2017). Age-specific cost effectiveness of using intravenous recombinant tissue plasminogen activator for treating acute ischemic stroke. Am J Prev Med, 53, S205–S212. doi:10.1016/j.amepre.2017.06.004.Google Scholar
Jurkowski, JM, Maniccia, DM, Spicer, DA, Dennison, BA. (2010). Impact of a multimedia campaign to increase intention to call 9–1-1 for stroke symptoms, upstate New York, 2006–2007. Prev Chronic Dis, 7, A35.Google Scholar
Katz, BS, McMullan, JT, Sucharew, H, Adeoye, O, Broderick, JP. (2015). Design and validation of a prehospital scale to predict stroke severity: Cincinnati Prehospital Stroke Severity Scale. Stroke, 46, 1508–12. doi:10.1161/STROKEAHA.115.008804.CrossRefGoogle ScholarPubMed
Kelly, AG, Hellkamp, AS, Olson, D, Smith, EE, Schwamm, LH. (2012). Predictors of rapid brain imaging in acute stroke: analysis of the Get with the Guidelines-Stroke program. Stroke J Cereb Circ, 43, 1279–84. doi:10.1161/STROKEAHA.111.626374.Google Scholar
Kidwell, CS, Saver, JL, Schubert, GB, Eckstein, M, Starkman, S. (1998). Design and retrospective analysis of the Los Angeles prehospital stroke screen (LAPSS). Prehosp Emerg Care, 2, 267–73. doi:10.1080/10903129808958878.Google Scholar
Kidwell, CS, Starkman, S, Eckstein, M, Weems, K, Saver, JL. (2000). Identifying stroke in the field. Prospective validation of the Los Angeles prehospital stroke screen (LAPSS). Stroke J Cereb Circ, 31, 71–6.Google Scholar
Kleindorfer, D, Xu, Y, Moomaw, CJ, Khatri, P, Adeoye, O, Hornung, R. (2009). US geographic distribution of rt-PA utilization by hospital for acute ischemic stroke. Stroke, 40, 3580–4. doi:10.1161/STROKEAHA.109.554626.Google Scholar
Knopf, L, Staff, I, Gomes, J. (2012). Impact of a neurointensivist on outcomes in critically ill stroke patients. Neurocrit Care, 16, 63–71. doi:10.1007/s12028-011-9620-x.Google Scholar
Kothari, RU, Pancioli, A, Liu, T, Brott, T, Broderick, J. (1999). Cincinnati Prehospital Stroke Scale: reproducibility and validity. Ann Emerg Med, 33, 373–8.Google Scholar
Leira, EC, Ahmed, A, Lamb, DL, Olalde, HM, Callison, RC, Torner, JC, et al. (2009). Extending acute trials to remote populations a pilot study during interhospital helicopter transfer. Stroke, 40, 895–901. doi:10.1161/STROKEAHA.108.530204.Google Scholar
Leira, EC, Lamb, DL, Nugent, AS, Azeemuddin, A, Grimsman, KJ, Clarke, WR, et al. (2006). Feasibility of acute clinical trials during aerial interhospital transfer. Stroke, 37, 2504–7. doi:10.1161/01.STR.0000239661.07675.9d.Google Scholar
Liman, TG, Winter, B, Waldschmidt, C, Zerbe, N, Hufnagl, P, Audebert, HJ. (2012). Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study. Stroke, 43, 2086–2090. doi :10.1161/STROKEAHA.112.657270.Google Scholar
Lin, CB, Peterson, ED, Smith, EE, Saver, JL, Liang, L, Xian, Y, et al. (2012). Emergency medical service hospital prenotification is associated with improved evaluation and treatment of acute ischemic stroke. Circ Cardiovasc Qual Outcomes, 5, 514–22. doi:10.1161/CIRCOUTCOMES.112.965210.Google Scholar
Lindsay, MP, Norrving, B, Furie, KL, Donnan, G, Langhorne, P, Davis, S, on behalf of the World Stroke Organization Global Stroke Quality and Guidelines Advisory Committee. (2016). Global stroke guidelines and action plan: a road map for quality stroke care. www.world-stroke.org/images/GSGAAP/Global_Stroke_Guidelines_and_Action_Plan_All_in_one.pdf. Accessed December 2018.Google Scholar
Madsen, TE, Baird, KA, Silver, B, Gjelsvik, A. (2015). Analysis of gender differences in knowledge of stroke warning signs. J Stroke Cerebrovasc Dis, 24(7), 1540–7. doi:10.1016/j.jstrokecerebrovasdis.2015.03.017.Google Scholar
Madsen, TE, Sucharew, H, Katz, B, Alwell, KA, Moomaw, CJ, Kissela, BM, et al. (2016). Gender and time to arrival among ischemic stroke patients in the Greater Cincinnati/Northern Kentucky Stroke Study. J Stroke Cerebrovasc Dis, 25(3), 504–10. doi:10.1016/j.jstrokecerebrovasdis.2015.10.026.Google Scholar
Massachusetts Health Promotions Clearinghouse. (2018). https://massclearinghouse.ehs.state.ma.us/mm5/merchant.mvc?Session_ID=77925787535d2a643e9b77bc3fe1539d&Screen=SRCH. Accessed December 2018.Google Scholar
Matsuo, R, Yamaguchi, Y, Matsushita, T, Hata, J, Kiyuna, F, Fukuda, K, et al.; Fukuoka Stroke Registry Investigators. (2017). Association between onset-to-door time and clinical outcomes after ischemic stroke. Stroke, 48, 3049–56. doi:10.1161/STROKEAHA.117.018132.Google Scholar
McKinney, JS, Mylavarapu, K, Lane, J, Roberts, V, Ohman-Strickland, P, Merlin, MA. (2013). Hospital prenotification of stroke patients by emergency medical services improves stroke time targets. J Stroke Cerebrovasc Dis, 22, 113–18. doi:10.1016/j.jstrokecerebrovasdis.2011.06.018.CrossRefGoogle ScholarPubMed
McMullan, JT, Katz, B, Broderick, J, Schmit, P, Sucharew, H, Adeoye, O. (2017). prospective prehospital evaluation of the Cincinnati Stroke Triage Assessment Tool. Prehosp Emerg Care, 21, 481–8. doi:10.1080/10903127.2016.1274349.Google Scholar
McTaggart, RA. Yagh, S, Cutting, SM, Hemendinger M, Baird GL, Haas RA, et al. (2017). Association of a primary stroke center protocol for suspected stroke by large-vessel occlusion with efficiency of care and patient outcomes. JAMA Neurol, 74, 793–800. doi:10.1001/jamaneurol.2017.0477.Google Scholar
Mellon, L, Doyle, F, Rohde, D, Williams, D, Hickey, A. (2015). Stroke warning campaigns: delivering better patient outcomes? A systematic review. Patient Relat Outcome Meas, 6, 61–73. doi:10.2147/PROM.S54087.Google Scholar
Meretoja, A, Roine, RO, Kaste, M, Linna, M, Roine, S, Juntunen, M, et al. (2010). Effectiveness of primary and comprehensive stroke centers PERFECT stroke: a nationwide observational study from Finland. Stroke, 41, 1102–1107. doi:10.1161/STROKEAHA.109.577718.CrossRefGoogle Scholar
Meyer, BC, Raman, R, Hemmen, T, Obler, R, Zivin, JA, Rao, R, et al. (2008). Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol, 7, 787–95. doi:10.1016/S1474-4422(08)70171-6.Google Scholar
Mission: Lifeline Stroke. (2017). Severity-based stroke triage algorithm for EMS. www.heart.org/idc/groups/ahaecc-public/@wcm/@gwtg/documents/downloadable/ucm_498615.pdf. Accessed December 2018.Google Scholar
Mitchell, JR, Sharma, P, Modi, J, Simpson, M, Thomas, M, Hill, MD, et al. (2011). A smartphone client-server teleradiology system for primary diagnosis of acute stroke. J Med Internet Res, 13, e31. doi:10.2196/jmir.1732.Google Scholar
Mochari‐Greenberger, H, Xian, Y, Hellkamp, AS, Schulte, PJ, Bhatt, DL, Fonarow, GC, et al. (2015). Racial/ethnic and sex differences in emergency medical services transport among hospitalized US stroke patients: analysis of the National Get with the Guidelines-Stroke registry. J Am Heart Assoc, 4, e002099. doi:10.1161/JAHA.115.002099.Google Scholar
Morgenstern, LB, Gonzales, NR, Maddox, KE, Brown, DL, Karim, AP, Espinosa, N, et al. (2007). A randomized, controlled trial to teach middle school children to recognize stroke and call 911: the kids identifying and defeating stroke project. Stroke J Cereb Circ, 38, 2972–8. doi:10.1161/STROKEAHA.107.490078.Google Scholar
Morgenstern, LB, Staub, L, Chan, W, Wein, TH, Bartholomew, LK, King, M, et al. (2002). Improving delivery of acute stroke therapy: the TLL Temple Foundation Stroke Project. Stroke J Cereb Circ, 33, 160–6.Google Scholar
Mosley, I, Nicol, M, Donnan, G, Dewey, H. (2007). Stroke symptoms and the decision to call for an ambulance. Stroke, 38, 361–366. doi:10.1161/01.STR.0000254528.17405.cc.Google Scholar
Nazliel, B, Starkman, S, Liebeskind, DS, Ovbiagele, B, Kim, D, Sanossian, N, et al. (2008). A brief prehospital stroke severity scale identifies ischemic stroke patients harboring persisting large arterial occlusions. Stroke, 39, 2264–7. doi:10.1161/STROKEAHA.107.508127.Google Scholar
Nelson, RE, Saltzman, GM, Skalabrin, EJ, Demaerschalk, BM, Majersik, JJ. (2011). The cost-effectiveness of telestroke in the treatment of acute ischemic stroke. Neurology, 77, 1590–8. doi:10.1212/WNL.0b013e318234332d.Google Scholar
Nishikawa, T, Okamura, T, Nakayama, H, Miyamatsu, N, Morimoto, A, Toyoda, K, et al. (2016). Effects of a public education campaign on the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset: the Acquisition of Stroke Knowledge (ASK) Study. J Epidemiol, 26(3), 115–22. doi:10.2188/jea.JE20150040.Google Scholar
Noorian, AR, Sanossian, N, Shkirkova, K, Liebeskind, DS, Eckstein, M, Stratton, SJ, et al.; FAST-MAG Trial Investigators and Coordinators. (2018). Los Angeles Motor Scale to Identify Large Vessel Occlusion: prehospital validation and comparison with other screens. Stroke, 49, 565–72. doi:10.1161/STROKEAHA.117.019228.Google Scholar
Olson, MD, Rabinstein, AA. (2012). Does helicopter emergency medical service transfer offer benefit to patients with stroke? Stroke, 43, 878–80. doi:10.1161/STROKEAHA.111.640987.Google Scholar
Oostema, JA, Chassee, T, Reeves, M. (2018). Emergency dispatcher stroke recognition: associations with downstream care. Prehosp Emerg Care, 22, 466–471. doi:10.1080/10903127.2017.1405131.Google Scholar
Oostema, JA, Konen, J, Chassee, T, Nasiri, M, Reeves, MJ. (2015). Clinical predictors of accurate prehospital stroke recognition. Stroke, 46, 1513–17. doi:10.1161/STROKEAHA.115.008650.Google Scholar
Pandey, AS, Gemmete, JJ, Wilson, TJ, Chaudhary, N, Thompson, BG, Morgenstern, LB, et al. (2015). High subarachnoid hemorrhage patient volume associated with lower mortality and better outcomes. Neurosurgery, 77, 462–70; doi:10.1227/NEU.0000000000000850.Google Scholar
Patel, MD, Rose, KM, O’Brien, EC, Rosamond, WD. (2011). Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina Stroke Care Collaborative. Stroke, 42, 2263–8. doi:10.1161/STROKEAHA.110.605857.Google Scholar
Perez de la Ossa, N, Carrera, D, Gorchs, M, Querol, M, Millan, M, Gomis, M, et al. (2014). Design and validation of a prehospital stroke scale to predict large arterial occlusion: the Rapid Arterial Occlusion Evaluation Scale. Stroke, 45, 87–91. doi:10.1161/STROKEAHA.113.003071.Google Scholar
Phabphal, K, Hirunpatch, S. (2008). The effectiveness of low-cost teleconsultation for emergency head computer tomography in patients with suspected stroke. J Telemed Telecare, 14, 439–42. doi:10.1258/jtt.2008.080603.Google Scholar
Powers, WJ, Rabinstein, AA, Ackerson, T, Adeoye, OM, Bambakidis, NC, Becker, K, et al.; American Heart Association Stroke Council. (2018). 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 49, e46–e110.Google Scholar
Puetz, V, Bodechtel, U, Gerber, JC, Dzialowski, I, Kunz, A, Wolz, M, et al. (2013). Reliability of brain CT evaluation by stroke neurologists in telemedicine. Neurology, 80, 332–8. doi:10.1212/WNL.0b013e31827f07d0.Google Scholar
Ramanujam, P, Guluma, KZ, Castillo, EM, Chacon, M, Jensen, MB, Patel, E, et al. (2008). Accuracy of stroke recognition by emergency medical dispatchers and paramedics – San Diego experience. Prehosp Emerg Care, 12, 307–13. doi:10.1080/10903120802099526.Google Scholar
Regenhardt, RW, Mecca, AP, Flavin, SA, Boulouis, G, Lauer, A, Zachrison, KS, et al. (2018). Delays in the air or ground transfer of patients for endovascular thrombectomy. Stroke, 49, 1419–25. doi:10.1161/STROKEAHA.118.020618.Google Scholar
Reginella, R, Crocco, T, Tadros, A, Shackleford, A, Davis, SM. (2006). Predictors of stroke during 9-1-1 calls: opportunities for improving EMS response. Prehosp Emerg Care, 10, 369–73.Google Scholar
Reiner-Deitemyer, V, Teuschl, Y, Matz, K, Reiter, M, Eckhardt, R, Seyfang, L, et al. (2011). Helicopter transport of stroke patients and its influence on thrombolysis rates: data from the Austrian Stroke Unit Registry. Stroke, 42, 1295–1300. doi:10.1161/STROKEAHA.110.604710.Google Scholar
Richards, CT, Wang, B, Markul, E, Albarran, F, Rottman, D, Aggarwal, NT, et al. (2017). Identifying key words in 9-1-1 calls for stroke: a mixed methods approach. Prehosp Emerg Care, 21, 761–766. doi:10.1080/10903127.2017.1332124.Google Scholar
Rose, KM, Rosamond, WD, Huston, SL, Murphy, CV, Tegeler, CH. (2008). Predictors of time from hospital arrival to initial brain-imaging among suspected stroke patients: the North Carolina Collaborative Stroke Registry. Stroke, 39, 3262–7. doi:10.1161/STROKEAHA.108.524686.Google Scholar
Rudd, M, Buck, D, Ford, GA, Price, CI. (2016). A systematic review of stroke recognition instruments in hospital and prehospital settings. Emerg Med J, 33, 818–822. doi:10.1136/emermed-2015-205197.Google Scholar
Sairanen, T, Soinila, S, Nikkanen, M, et al. (2011). Two years of Finnish Telestroke Thrombolysis at spokes equal to that at the hub. Neurology, 76, 1145–52. doi:10.1212/WNL.0b013e318212a8d4.Google Scholar
Sauser, K, Burke, JF, Levine, DA, Scott, PA, Meurer, WJ. (2014a). Time to brain imaging in acute stroke is improving: secondary analysis of the INSTINCT trial. Stroke J Cereb Circ, 45, 287–9. doi:10.1161/STROKEAHA.113.003678Google Scholar
Sauser, K, Levine, DA, Nickles, AV, Reeves, MJ. (2014b). Hospital variation in thrombolysis times among patients with acute ischemic stroke: the contributions of door-to-imaging time and imaging-to-needle time. JAMA Neurol, 71, 1155. doi:10.1001/jamaneurol.2014.1528.CrossRefGoogle ScholarPubMed
Saver, JL, Starkman, S, Eckstein, M, Stratton, SJ, Pratt, FD, Hamilton, S, et al. (2015). Prehospital use of magnesium sulfate as neuroprotection in acute stroke. N Engl J Med, 372, 528–536. doi:10.1056/NEJMoa1408827.Google Scholar
Schwab, S, Vatankhah, B, Kukla, C, Hauchwitz, M, Bogdahn, U, Furst, A, et al. (2007). Long-term outcome after thrombolysis in telemedical stroke care. Neurology, 69, 898–903. doi:10.1212/01.wnl.0000269671.08423.14.Google Scholar
Schwamm, LH, Audebert, HJ, Amarenco, P, Chumbler, NR, Frankel, MR, George, MG, et al. (2009a). Recommendations for the implementation of telemedicine within stroke systems of care: a policy statement from the American Heart Association. Stroke, 40, 2635–60. doi:10.1161/STROKEAHA.109.192361.Google Scholar
Schwamm, LH, Holloway, RG, Amarenco, P, Audebert, HJ, Bakas, T, Chumbler, NR, et al. (2009b). A review of the evidence for the use of telemedicine within stroke systems of care: a scientific statement from the American Heart Association/American Stroke Association. Stroke, 40, 2616–34. doi:10.1161/STROKEAHA.109.192360.Google Scholar
Schwamm, LH, Pancioli, A, Acker, JE 3rd, Goldstein, LB, Zorowitz, RD, Shephard, TJ, et al. (2005). Recommendations for the establishment of stroke systems of care recommendations from the American Stroke Association’s Task Force on the Development of Stroke Systems. Stroke, 36, 690–703. doi:10.1161/01.STR.0000158165.42884.4F.Google Scholar
Schwamm, LH, Rosenthal, ES, Hirshberg, A, Schaefer, PW, Little, EA, Dvedar, JC, et al. (2004). Virtual TeleStroke support for the emergency department evaluation of acute stroke. Acad Emerg Med, 11, 1193–1197. doi:10.1197/j.aem.2004.08.014.Google Scholar
Shafqat, S, Kvedar, JC, Guanci, MM, Chang, Y, Schwamm, LH. (1999). Role for telemedicine in acute stroke feasibility and reliability of remote administration of the NIH Stroke Scale. Stroke, 30, 2141–5. doi:10.1161/01.STR.30.10.2141.Google Scholar
Shireman, TI, Wang, K, Saver, JL, Goyal, M, Bonafe, A, Diener, HC, et al. (2017). Cost-effectiveness of solitaire stent retriever thrombectomy for acute ischemic stroke: results from the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke). Stroke, 48, 379–87. doi:10.1161/STROKEAHA.116.014735.Google Scholar
Silbergleit, R, Scott, PA, Lowell, MJ, Silbergleit, R. (2003). Cost-effectiveness of helicopter transport of stroke patients for thrombolysis. Acad Emerg Med Off J Soc Acad Emerg Med, 10, 966–72.Google Scholar
Silliman, SL, Quinn, B, Huggett, V, Merino, JG. (2003). Use of a field-to-stroke center helicopter transport program to extend thrombolytic therapy to rural residents. Stroke J Cereb Circ, 34, 729–33. doi:10.1161/01.STR.0000056529.29515.B2.Google Scholar
Smith, EE, Hassan, KA, Fang, J, Selchen, D, Kapral, MK, Saposnik, G, et al. (2010). Do all ischemic stroke subtypes benefit from organized inpatient stroke care? Neurology, 75, 456–62. doi:10.1212/WNL.0b013e3181ebdd8d.Google Scholar
Song, S, Fonarow, GC, Olson, DM, Liang, L, Schulte, PG, Hernandez, AF, et al. (2016). Association of Get with the Guidelines-Stroke Program participation and clinical outcomes for Medicare beneficiaries with ischemic stroke. Stroke, 47, 1294–302. doi:10.1161/STROKEAHA.115.011874.Google Scholar
Stroke Unit Trialists’ Collaboration. (2013). Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev, 9. CD000197. doi:10.1002/14651858.CD000197.pub3.Google Scholar
Sung, S-F, Ong, C-T, Wu, C-S, Hsu, YC, Su, YH. (2010). Increased use of thrombolytic therapy and shortening of in-hospital delays following acute ischemic stroke: experience on the establishment of a primary stroke center at a community hospital. Acta Neurol Taiwanica, 19, 246–52.Google Scholar
Svenson, JE, O’Connor, JE, Lindsay, MB. (2006). Is air transport faster? A comparison of air versus ground transport times for interfacility transfers in a regional referral system. Air Med J, 25, 170–2. doi:10.1016/j.amj.2006.04.003.Google Scholar
Switzer, JA, Hall, C, Gross, H, Waller, J, Nichols, FT, Wang, S, et al. (2009). A web-based telestroke system facilitates rapid treatment of acute ischemic stroke patients in rural emergency departments. J Emerg Med, 36, 12–18. doi:10.1016/j.jemermed.2007.06.041.Google Scholar
Tang, Y, Yin, F, Fu, D, Gao, X, LV Z, LI X, et al. (2018). Efficacy and safety of minimal invasive surgery treatment in hypertensive intracerebral hemorrhage: a systematic review and meta-analysis. BMC Neurol, 18, 136. doi:10.1186/s12883-018-1138-9.Google Scholar
Thompson, MP, Zhao, X, Bekelis, K, Gottlieb, DJ, Fonarow, GC, Schulte, PJ, et al. (2017). Regional variation in 30-day ischemic stroke outcomes for Medicare beneficiaries treated in Get With the Guidelines-Stroke Hospitals. Circ Cardiovasc Qual Outcomes, 10. pii: e003604. doi:10.1161/CIRCOUTCOMES.117.003604.CrossRefGoogle ScholarPubMed
Van Hooff, R-J, Cambron, M, Van Dyck, R, De Smedt, A, Moens, M, Espinoza, AV, et al. (2013). Prehospital unassisted assessment of stroke severity using telemedicine: a feasibility study. Stroke, 44, 2907–9. doi:10.1161/STROKEAHA.113.002079.Google Scholar
Waite, K, Silver, F, Jaigobin, C, Black, S, Lee, L, Murray, B, et al. (2006). Telestroke: a multi-site, emergency-based telemedicine service in Ontario. J Telemed Telecare, 12, 141–5.Google Scholar
Wall, HK, Beagan, BM, O’Neill, HJ, Foell, KM, Boddie-Willis, CL. (2008).Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST Campaign. Prev Chronic Dis, 5, A49.Google Scholar
Walter, S, Kostopoulos, P, Haass, A, Keller, I, Lesmeister, M, Schlechtriemen, T, et al. (2012). Diagnosis and treatment of patients with stroke in a mobile stroke unit versus in hospital: a randomised controlled trial. Lancet Neurol, 11, 397–404. doi:10.1016/S1474-4422(12)70057-1.Google Scholar
Wang, S, Gross, H, Lee, SB, Pardue, C, Waller, J, Nichols, FT 3rd, et al. (2004). Remote evaluation of acute ischemic stroke in rural community hospitals in Georgia. Stroke, 35, 1763–8. doi:10.1161/01.STR.0000131858.63829.6e.Google Scholar
Wang, S, Lee, SB, Pardue, C, Ramsingh, D, Waller, J, Gross, H, et al. (2003). Remote evaluation of acute ischemic stroke: reliability of National Institutes of Health Stroke Scale via telestroke. Stroke J Cereb Circ, 34, e188–91. doi:10.1161/01.STR.0000091847.82140.9D.Google Scholar
Watkins CL, Jones SP, Leathley MJ, et al. Emergency Stroke Calls: Obtaining Rapid Telephone Triage (ESCORTT) – a programme of research to facilitate recognition of stroke by emergency medical dispatchers. Southampton (UK): NIHR Journals Library; February 2014.Google Scholar
Wiborg, A, Widder, B; Group for the TS. (2003). Teleneurology to improve stroke care in rural areas: the Telemedicine in Stroke in Swabia (TESS) Project. Stroke, 34, 2951–6. doi:10.1161/01.STR.0000099125.30731.97.Google Scholar
Williams, O, Noble, JM. (2008). ‘Hip-Hop’ stroke: a stroke educational program for elementary school children living in a high-risk community . Stroke, 39, 2809–16. doi:10.1161/STROKEAHA.107.513143.Google Scholar
Wu, T-C, Nguyen, C, Ankrom, C, Yang, J, Persse, D, Vahidy, F, et al. (2014). Prehospital utility of rapid stroke evaluation using in-ambulance telemedicine: a pilot feasibility study. Stroke, 45, 2342–7. doi:10.1161/STROKEAHA.114.005193.Google Scholar
Xian, Y. (2011). Association between stroke center hospitalization for acute ischemic stroke and mortality. JAMA, 305, 373. doi:10.1001/jama.2011.22.Google Scholar
Zhao, H, Coote, S, Pesavento, L, Churilov, L, Dewey, HM, Davis, SM, Campbell, BC. (2017). Large vessel occlusion scales increase delivery to endovascular centers without excessive harm from misclassifications. Stroke, 48, 568–73. doi:10.1161/STROKEAHA.116.016056.Google Scholar
Zhao, J, Eckenhoff, MF, Sun, WZ, Liu, R. (2018). Stroke 112: a universal stroke awareness program to reduce language and response barriers. Stroke, 49, 1766–9. doi:10.1161/STROKEAHA.118.021729.Google Scholar

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