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Characterizing Strokes and Stroke Mimics Transported by Helicopter Emergency Medical Services
Prehospital Emergency Care
|April 16, 2016
Summary
Approximately 20% of potential stroke patients transported by helicopter emergency medical services (HEMS) were stroke mimics. Accurate prehospital triage is crucial for directing patients to appropriate stroke care facilities, improving outcomes.
Area of Science:
- Emergency Medicine
- Neurology
- Public Health
Background:
- Stroke is a leading cause of disability in the U.S., necessitating rapid identification and transport by emergency medical services (EMS).
- Prehospital providers face challenges in accurately differentiating stroke from conditions with similar symptoms, impacting triage decisions.
- Timely and appropriate transport to specialized facilities is critical for effective stroke treatment.
Purpose of the Study:
- To analyze the frequency of stroke mimics among patients suspected of stroke and transported by helicopter emergency medical services (HEMS).
- To evaluate the impact of transfer type (scene vs. interfacility) on the incidence of stroke mimics.
- To inform the development of prehospital triage tools for optimizing stroke patient care.
Main Methods:
- A retrospective observational study analyzed data from 2007-2013 for patients transported by HEMS with suspected strokes.
- Final diagnoses were obtained from the Get with the Guidelines (GWTG) database and hospital discharge records.
- Discharge diagnoses were categorized and stratified by transfer type (scene vs. interfacility).
Main Results:
- Out of 3,376 potential stroke patients transported by HEMS, 2,527 were confirmed strokes (including ischemic stroke and transient ischemic attack), 166 had intracranial hemorrhage, and 655 were stroke mimics.
- Stroke mimics constituted approximately 20% of all potential stroke patients.
- Stroke mimics were more prevalent in scene transfers (32%) compared to interfacility transfers (16%).
Conclusions:
- A significant proportion of patients transported by HEMS for suspected stroke are ultimately diagnosed with conditions other than stroke (stroke mimics).
- Understanding the prevalence of stroke mimics, particularly in different transport scenarios, is vital for refining prehospital triage protocols.
- Developing improved prehospital triage tools can enhance the efficient allocation of comprehensive stroke center (CSC) resources and ensure patients receive timely, appropriate care.
