Advanced prehospital stroke triage in the era of mechanical thrombectomy
Luke Morrison
Tuesday, April 2, 2019
Direct transport to a comprehensive stroke centre that is capable of endovascular thrombectomy may improve outcomes in patients with large vessel occlusive stroke. A number of prehospital triage tools have been developed to see if clinicians can predict which patients would benefit from this procedure, allowing them to bypass a primary stroke centre in preference for a comprehensive stroke centre. A literature search was performed across a number of medical databases; six triage tools were selected for analysis based on their reported accuracy and prevalence in clinical trials. Additionally, a number of articles were isolated for the analysis of changing systems of care for patients who had had a stroke. This narrative review integrates how these variously accurate triage tools could benefit patients and outlines why changes to the system of care for stroke patients require a ground-upwards, local approach. The accuracy of the triage tools analysed varied, with some lacking specificity and others sensitivity. Triage tools are evolving, and simplistic tools offer comparable accuracy when contrasted with comprehensive alternatives, which require a significantly increased level of assessment skill and time demand. While there is evidence in support of prehospital bypass protocols, this evidence is poorly generalisable owing to a number of variables, with geographical layout being a significant compounding factor.
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for vising the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
CPD Focus
Reading the Journal of Paramedic Practice counts towards your professional development
Develop your career
We provide professional information dedicated to paramedics covering training, education and jobs
Stay informed
Get the latest clinical information to ensure you are aware of the latest think and best practice in paramedicne
Subscribe now
Already registered? - Sign in here