References
Hyperacute stroke unit training for paramedics
Abstract
Background
The best outcomes for acute stroke treatment occur through rapid recognition and transfer of patients to hospitals with a hyperacute stroke unit (HASU). Pre-hospital ambulance paramedics are crucial to this process as first responders, but they have limited feedback on subsequent patient care and progress to improve their learning.
Methods
A dedicated stroke training course for paramedics was developed on a HASU that involved a standardised introductory educational briefing and subsequent participation in clinical activities with multidisciplinary HASU staff. On completion of the course, attendees completed a standardised semi-structured questionnaire about their learning and experience. All text was thematically analysed and themes were developed by iteratively recoding and regrouping the data.
Results
30 paramedics attended the training course over a three-month period. All candidates reported that the course was useful to their learning and training with ‘real-world’ transferability; 93% stated that they benefited from observing clinicians performing assessments on patients and 73% commented that they gained a better understanding of care pathways and treatment. These two themes encompassed 48% of 160 free-text responses with the other responses being grouped into four further themes (improved patient/family communication, increased awareness of subtle signs of stroke, localisation of intracranial pathology, and improved ‘handover’).
Discussion
This single centre experience of HASU training for paramedics demonstrated a number of key educational themes embedded within the stroke care pathway. This process may be a useful additional educational resource to develop further paramedic training in the hyperacute arena.
Stroke is the third most common cause of death and largest cause of adult disability, costing the UK economy approximately £7 billion per annum. Clinical guidelines have emphasised the need to identify acute stroke as a clinical priority requiring specialist assessment and treatment (Royal College of Physicians, 2012). There has been increasing recognition of the importance of timely medical attention in acute stroke management to facilitate early diagnosis and determination of the aetiology of the stroke (ischaemic or haemorrhagic) in addition to planning treatment strategies aimed at reducing the brain damage caused by the stroke and preventing complications (Stone, 2002; Harbison et al, 2003; Nor et al, 2005). Indeed, ‘clot-busting’ treatment with thrombolysis within three hours of ischaemic stroke onset results in a 30% increase in the number of patients with no or minimal disability at three months (National Institute of Neurological Disorders and Stroke, 1995). It is widely acknowledged that a team-orientated collaborative approach to patient care on stroke units improves safety and outcomes, with significant reductions in patient death, dependency and institutionalisation (Stone, 2002; Kalra et al, 2000; Evans et al, 2001; Frisby et al, 2015; Stroke Unit Trialists' Collaboration, 2013). Effective interdisciplinary team-working across primary and secondary care interfaces also contributes to the delivery of safe and high-quality care (Birns et al, 2009; Royal College of Physicians, 2012).
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for visiting 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.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed