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Reducing Door-In to Door-Out Time for Patients Receiving a Mechanical Thrombectomy Using AutoLaunch Protocol.

Devin M Howell1,2, Timmy Li1, Elizabeth Quellhorst2

  • 1Department of Emergency Medicine, Northwell Health, Manhasset, NY, USA.

Open Access Emergency Medicine : OAEM
|October 23, 2023
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Summary

Implementing an AutoLaunch protocol for large vessel occlusion (LVO) stroke transfers significantly reduced door-in to door-out (DIDO) times at Comprehensive Stroke Centers (CSCs). This streamlined process improves efficiency for critical stroke care.

Keywords:
AutoLaunchEMSinterfacilitystroketransfer

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Healthcare Management

Background:

  • Door-in to door-out (DIDO) time is a key performance metric for large vessel occlusion (LVO) stroke care.
  • Patients initially presenting at non-Comprehensive Stroke Centers (CSCs) require efficient interfacility transfers.
  • Minimizing delays in stroke care is critical for patient outcomes.

Purpose of the Study:

  • To evaluate the impact of an AutoLaunch protocol on DIDO times for interfacility stroke transfers.
  • To determine if the AutoLaunch protocol reduces delays compared to traditional dispatch methods.
  • To assess the effectiveness of a new protocol in optimizing stroke patient logistics.

Main Methods:

  • A pre-post analysis was conducted comparing AutoLaunch and traditional dispatch protocols.
  • The study included all acute stroke patients transferred to a CSC for mechanical thrombectomy.
  • DIDO times were compared between the two transfer groups.

Main Results:

  • A total of 92 interfacility transfers were analyzed (22 AutoLaunch, 70 traditional).
  • The median DIDO time for AutoLaunch transfers was 85 minutes (IQR: 71, 133).
  • The median DIDO time for traditional transfers was 109 minutes (IQR: 84, 144), with a statistically significant reduction (p=0.044) for AutoLaunch.

Conclusions:

  • The AutoLaunch protocol significantly reduced DIDO time for LVO stroke patients transferred to CSCs.
  • This protocol demonstrates a potential improvement in stroke care logistics.
  • Further research is recommended to correlate transfer strategies with patient outcomes.