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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Rural Field Consultation for Remote Acute Stroke Transport Decisions
Marie-Andrée Panzini1, Mary-Lou Halabi2, Jillian Stang3
1Department of Clinical Neurosciences, Centre Hospitalier Universite de Montreal, Montreal, Quebec, Canada.
Summary
A rural field consultation system improved acute stroke care for remote patients. This approach reduced delays to recanalization, demonstrating feasibility and enhancing access to stroke interventions.
Area of Science:
- Neurology
- Emergency Medicine
- Health Services Research
Background:
- Prehospital stroke transport strategies vary, especially for rural large vessel occlusion (LVO) cases.
- Lack of scene diagnosis complicates triage decisions for rural stroke patients.
- Alberta, Canada, implemented a rural field consultation approach for acute stroke care.
Purpose of the Study:
- To describe the implementation and 5-year experience of a rural field consultation system for acute stroke.
- To evaluate the impact of this system on patient transport and treatment delays.
Main Methods:
- Protocols for the rural field consultation system were established.
- Transport patterns for suspected stroke patients were analyzed over 5 years.
- Outcomes, including time to treatment, were summarized using descriptive statistics.
Main Results:
- 601 patients were analyzed from April 2017 to March 2022.
- Most patients (90%) arrived via ground ambulance.
- Rural field consultation was associated with shortened median time to arterial access (3.2h vs 6.5h) compared to indirect transfers.
Conclusions:
- The rural field consultation system is feasible for improving acute stroke care access in rural areas.
- This system demonstrated shortened delays to recanalization for rural stroke patients.
- Optimized triage and consultation improve outcomes for remote stroke populations.
