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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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Prehospital notification in acute stroke: a retrospective cohort study
Joshua Kimbrell1, Aditya C Shekhar2, Jacob Stebel1
1Department of Pre-Hospital Care, MediSys Health Network, Queens, New York, USA.
Proceedings (Baylor University. Medical Center)
|August 18, 2025
Summary
Emergency medical services (EMS) prehospital notification significantly reduces time to stroke diagnosis and treatment. This crucial step in emergency medical services care can improve patient outcomes by speeding up critical interventions like CT scans and IV thrombolysis.
Area of Science:
- Neurology
- Emergency Medicine
- Health Services Research
Background:
- Emergency medical services (EMS) are vital for identifying stroke patients and facilitating rapid transport to specialized stroke centers.
- Timely intervention is critical for improving outcomes in stroke care.
Purpose of the Study:
- To quantify the time savings achieved in stroke care through EMS prehospital notification.
- To evaluate the impact of prehospital notification on key stroke treatment metrics.
Main Methods:
- Retrospective cohort study at a major metropolitan stroke center.
- Inclusion of adult patients diagnosed with stroke or transient ischemic attack (TIA) transported by EMS between 2021-2022.
- Analysis of door-to-computed-tomography (CT) and time-to-treatment metrics based on prehospital notification status.
Main Results:
- Prehospital notification was provided for 60.5% of 1053 included patients.
- Notification was associated with a 3-minute decrease in median door-to-CT time (18 min vs. 21 min).
- Faster adjusted time-to-intravenous thrombolysis (IVT) was observed with notification (52 min vs. 63 min).
Conclusions:
- EMS prehospital notification significantly reduces door-to-CT and door-to-IVT times.
- Implementing prehospital notification in quality improvement initiatives can enhance stroke care delivery.
- Further research may explore the impact on endovascular thrombectomy (EVT) times.
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