Lack of impact of paramedic training and use of the cincinnati prehospital stroke scale on stroke patient identification and on-scene time.

نویسندگان

  • Daniel M Frendl
  • David G Strauss
  • B Kevin Underhill
  • Larry B Goldstein
چکیده

BACKGROUND AND PURPOSE The Cincinnati Prehospital Stroke Scale (CPSS) is recommended for emergency medical services use in identifying patients with stroke. Data evaluating its performance in the field are limited. We assessed the impact of training and use of the CPSS on the accuracy of paramedics' stroke patient identification and on-scene time. METHODS A 1-hour interactive educational presentation on the use of the CPSS was conducted for paramedics transporting patients to an academic medical center. Patients with stroke/transient ischemic attack (TIA) were identified retrospectively from paramedic records and were compared with the hospital's prospective stroke registry for the year before and after the training. RESULTS There were 154 patients with suspected stroke/transient ischemic attack identified (56% women, 53% white, 44% black, mean age 67+/-16 years). There was no difference in paramedics' use of the CPSS (37.5% versus 23.8%, P=0.123) or accuracy of stroke/TIA patient identification (40.5% versus 38.9%, P=0.859) before and after training. Of responsive patients identified by paramedics as having a stroke/TIA, 57% had an abnormality in at least one CPSS item with no effect on on-scene time (17+/-6 minutes with a normal versus 18+/-6 minutes with an abnormal CPSS, P=0.492). Those with a final diagnosis of stroke/TIA (n=61, 40%) more frequently had at least one abnormal CPSS item (70% versus 30%, P=0.008, sensitivity 0.71, specificity 0.52) with 49% of patients with an abnormality having a discharge diagnosis of stroke/TIA. CONCLUSIONS Paramedic training in the CPSS, or its use, had no impact on the accuracy of their identification of patients with stroke/TIA or on-scene time.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Different Stroke Scales; Which Scale or Scales Should Be Use?

Background: There has been considerable development in the clinometric of stroke. But, researcher is concerned that some scales are too generic, inherently and the insight may not be provided. The current study was conducted to determine which scale or scales should be used in stroke survivors. Methods: We selected 67 studies which published between January 2010 and December 2018 from Up to d...

متن کامل

Paramedic diagnosis of stroke: examining long-term use of the Melbourne Ambulance Stroke Screen (MASS) in the field.

BACKGROUND AND PURPOSE Recent evidence suggests the Cincinnati Prehospital Stroke Scale is ineffectively used and lacks sensitivity and specificity. Melbourne (Australia) paramedics have been using the Melbourne Ambulance Stroke Screen (MASS) since 2005. The aim of this study was to review the real-world use of MASS 3 years after city wide implementation. METHODS Two groups of consecutively a...

متن کامل

A Comparative Study of Prehospital Emergency Services Over the Urban and Road Areas in Hamedan Province

Background: Prehospital emergency care services are one of the vital health services in many countries that provide first and immediate medical care to the patients and injured people at the scene and during transfer to healthcare centers. This study was conducted to investigate and compare the use of prehospital emergency services in urban and road emergency bases of Hamadan University of Medi...

متن کامل

The use of Cincinnati prehospital stroke scale during telephone dispatch interview increases the accuracy in identifying stroke and transient ischemic attack symptoms

BACKGROUND Timely and appropriate hospital treatment of acute cerebrovascular diseases (stroke and Transient Ischemic Attacks - TIA) improves patient outcomes. Emergency Medical Service (EMS) dispatchers who can identify cerebrovascular disease symptoms during telephone requests for emergency service also contribute to these improved outcomes. The Italian Ministry of Health issued guidelines on...

متن کامل

Clinical predictors of accurate prehospital stroke recognition.

BACKGROUND AND PURPOSE Prehospital activation of in-hospital stroke response hastens treatment but depends on accurate emergency medical services (EMS) stroke recognition. We sought to measure EMS stroke recognition accuracy and identify clinical factors associated with correct stroke identification. METHODS Using EMS and hospital records, we assembled a cohort of EMS-transported suspect, con...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Stroke

دوره 40 3  شماره 

صفحات  -

تاریخ انتشار 2009