Impact of pre-hospital assessment of stroke on in-hospital care

Effective pre-hospital recognition and management of stroke is an important component of the acute stroke care pathway. The practice of placing a priority (pre-alert) call to hospitals to notify receiving staff that a stroke patient is in transit enables specialist care to be available immediately on the patient's arrival in an attempt to improve timeliness of subsequent treatment.

This research examines the relationship between pre-hospital assessment and management of stroke by ambulance staff on the patient's in-hospital stroke care pathway. The researchers had a particular interest in symptom onset time, stroke recognition using the FAST test, placing a priority call (all extracted from ambulance service records), and examining whether there was an association between these activities and the subsequent time that hospital staff then made the request for a CT scan and the actual time the patient received the scan (taken from in-hospital records).

The study utilised a cohort design involving patients who had a definitive diagnosis of stroke and who had experienced the acute stroke pathway in one of two participating hospitals between November 2010 and July 2011.