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Large Vessel Occlusion Stroke Detection in the Prehospital Environment
Lauren Patrick1, Wade Smith1, Kevin J Keenan2
1University of California San Francisco, 505 Parnassus Ave, S784, San Francisco, CA 94122, USA.
Current Emergency and Hospital Medicine Reports
|October 7, 2022
Summary
Prehospital triage for suspected large vessel occlusion (LVO) stroke is crucial. Advances in LVO detection tools and mobile stroke units aim to improve patient outcomes by enabling faster endovascular therapy.
Area of Science:
- Neurology
- Emergency Medicine
- Medical Technology
Background:
- Acute ischemic stroke due to large vessel occlusion (LVO) requires time-sensitive endovascular therapy.
- Prehospital triage to specialized stroke centers is essential for optimal patient outcomes.
- Early detection of LVO in prehospital settings is critical for timely intervention.
Purpose of the Study:
- To review recent advancements in detecting large vessel occlusion (LVO) in prehospital stroke patients.
- To highlight the importance of prehospital triage for LVO stroke.
- To discuss emerging technologies and strategies for LVO detection.
Main Methods:
- Review of clinical prehospital stroke severity tools.
- Evaluation of novel diagnostic devices (EEG, SSEPs, TCD, cranial accelerometry, volumetric impedance phase-shift-spectroscopy).
- Assessment of mobile stroke unit capabilities.
Main Results:
- Prehospital stroke severity tools are validated for LVO triage, with ease of use being a key factor.
- In-hospital data exists for LVO diagnostic devices, but prehospital validation is pending.
- Mobile stroke units demonstrate improved patient outcomes, with cost-effectiveness studies ongoing.
Conclusions:
- Prehospital stroke severity tools are recommended for LVO triage due to their validated performance and ease of use.
- Emerging LVO diagnostic devices show promise but require prehospital validation.
- Mobile stroke units offer significant benefits for acute stroke care, warranting further economic evaluation.
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