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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Evaluating Stroke Code Activation Pathway in Emergency Departments study.

Anja Ebker-White1,2, Michael Dinh2,3, Ian Paver2

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Summary
This summary is machine-generated.

Code Stroke activations in the emergency department (ED) identify stroke/TIA risk factors like age and symptoms. Ambulance pre-arrival notification improves diagnosis and speeds reperfusion therapy for stroke patients.

Keywords:
emergency departmentprehospitalprotocolstroke

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Clinical Research

Background:

  • Code Stroke activations are crucial for rapid stroke assessment in emergency departments (EDs).
  • Understanding predictors of stroke diagnosis and outcomes is vital for optimizing patient care.
  • Identifying factors influencing reperfusion therapy access is essential for improving stroke treatment.

Purpose of the Study:

  • To characterize clinical features and outcomes of Code Stroke activations.
  • To identify predictors for a final diagnosis of stroke or transient ischemic attack (TIA).
  • To evaluate factors affecting access to reperfusion therapies.

Main Methods:

  • Retrospective analysis of 1354 Code Stroke activations over two years at a quaternary stroke referral center.
  • Utilized Stroke Registry data and electronic medical records for clinical information.
  • Primary outcome: final stroke/TIA diagnosis; Secondary outcome: access to thrombolysis or endovascular clot retrieval.

Main Results:

  • 51% of Code Stroke activations resulted in a stroke or TIA diagnosis.
  • Increased age, pre-arrival ambulance notification, elevated blood pressure, weakness, or speech impairment predicted stroke risk.
  • Dizziness/vertigo were common alternative diagnoses; 10% received reperfusion therapy.

Conclusions:

  • In ED Code Stroke activations, age, blood pressure, and neurological deficits (weakness, speech impairment) increase stroke risk.
  • Prehospital notification by ambulance is associated with a higher stroke/TIA diagnosis rate and reduced door-to-needle times for thrombolysis.