New Data on Stroke Assessment Could Mean Change for EMS
The assessment and treatment of acute stroke patients by EMS technicians is on the cusp of a major shift, similar to that experienced in recent years for the screening and care of cardiac patients that lead to a change in how patients were screened, where they were transported, and how often they survived.
According to ESO Solutions Chief Medical Officer Brent Myers, MD, MPH, FACEP, FAEMS, an increase in data points and a wealth of new studies is questioning the old ways of screening stoke patients, suggesting that stroke assessment should be more specific, and that subsequent actions – from where the patient should be transported to the optimal window of treatment time – may all be shifted to improve care.
In a recent webinar, Myers reviewed the state of stroke assessment and treatment, examining the history that brings stroke emergency care to where it is today. According to the American Heart Association, someone in the U.S. has a stroke about once every 40 seconds. However, according to the ESO datasphere – a collection of 1.5 million records that providers share with ESO Solutions – EMS technicians only encounter stroke calls about 1% of the time. This creates a unique problem in that EMS technicians must be highly trained to identify and take appropriate next steps for a complicated and potentially life-threatening condition they may only encounter on rare occasions.
Compounding the challenge is that fact that existing stroke screening tools – there are numerous options and procedures with varying degrees of sensitivity and specificity success – could all use improvement, with some even using outdated paper models, making it difficult to review results after transport. Additionally, due to pervading belief that the faster a patient received stroke care, the better the chances for a good response, most EMS technicians were jumping to action as soon as the first positive credential for stroke were met. This resulted in more than 50% of stroke patients not receiving a full, complete pre-hospital stroke screen.
Emerging data is suggesting that completing a full, accurate assessment on a potential stroke patient can actually alter the next steps that an EMS technician should take. The options of where to take the patient and how to treat them are more complicated than ever, as more is being discovered about the different types of stroke and how they respond to specific treatment, such as new thrombectomy treatment. Optimal treatment time windows also appear to be shifting, based on the type of stroke, potentially giving providers more time to get the right treatment to the right patient.
Myers explains that the industry is facing data that is “overwhelming” in showing the right thing to do moving forward. But the question is now, how do we go about doing that right thing?
View the full webinar.