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09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
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Stroke Recognition for First Aid Providers: A Systematic Review and Meta-Analysis
Daniel Meyran1,2, Pascal Cassan3, Bert Avau4
1Healthcare Division, French Red Cross, Paris, FRA.
Cureus
|December 14, 2020
Summary
This systematic review found that prehospital stroke recognition scales improve stroke diagnosis and aid emergency services in triaging patients. Scales like FAST and CPSS are effective for first aid providers, especially when blood glucose measurement is not feasible.
Area of Science:
- Emergency Medicine
- Neurology
- Public Health
Background:
- Stroke recognition in prehospital settings is crucial for timely treatment.
- Existing stroke recognition scales require evaluation for first aid provider use.
- International first aid guidelines need updating based on evidence.
Purpose of the Study:
- To systematically review the effectiveness of prehospital stroke recognition scales for first aid providers.
- To inform updates to international first aid guidelines regarding stroke recognition.
- To identify the most sensitive and specific stroke scales for prehospital use.
Main Methods:
- Systematic literature review following Cochrane Handbook and PRISMA guidelines.
- Searched Medline, Embase, and CENTRAL for studies on stroke scales in prehospital settings.
- Evaluated 24 observational studies (10,446 patients) using GRADE methodology for evidence certainty.
Main Results:
- Ten stroke scales were evaluated; evidence certainty was moderate to very low.
- FAST, KPSS, and OPSS scales improved patient arrival times and thrombolytic therapy rates.
- FAST, CPSS, and LAPSS scales demonstrated high sensitivity and improved diagnostic accuracy.
Conclusions:
- Prehospital stroke recognition scales enhance stroke recognition and diagnosis, improving patient triage.
- FAST and MASS scales showed the highest sensitivity for stroke recognition.
- FAST and CPSS are suitable for non-medical first aid providers due to their simplicity.
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