Cincinnati Prehospital Stroke Scale: Reproducibility and Validity☆,☆☆,★,★★
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INTRODUCTION
Early recognition and prompt medical evaluation is critical for the use of thrombolytic therapy for patients with acute ischemic stroke. Patients must be treated with tissue plasminogen activator (t-PA) within 180 minutes of symptom onset for the treatment to be effective.1 To accomplish this, clinical centers have emphasized “prehospital education” and “en-route notification by EMS personnel.”2 Anecdotal experience at the University of Cincinnati indicated that early notification by paramedics
MATERIALS AND METHODS
A total of 24 prehospital care providers (17 paramedics and 7 EMTs) from University of Cincinnati Mobile Care Unit were evaluated during 23 different sessions. Groups of 4 to 11 patients with or without a final discharge diagnosis of stroke were identified from the ED and the inpatient neurology service for each of these 23 different sessions. The testing physician identified a convenience sample of patients from the ED. An attempt was made to identify patients with chief complaints that were
RESULTS
A total of 860 scales were completed on 171 patients. Of these patients, 38 had a final diagnosis of stroke and 11 a final diagnosis of TIA. There was no difference in terms of race or sex between stroke/TIA and nonstroke patients; however, nonstroke patients were significantly younger (mean difference, 6.7 years, 95% CI, 11.7 to 1.7 years), as shown in Table 1.
Variable All Patients Stroke/TIA Nonstroke No. patients 171 49 122 Mean age (y) 57.8 62.5 55.8 No. (%) male 72 (42) 17 (35) 55
DISCUSSION
The rapid identification of potential stroke patients and early ED notification are important components of the prehospital management of stroke patients.9 The CPSS is a 3-item neurologic examination that was developed to assist paramedics and EMTs in identifying patients with stroke who are candidates for thrombolysis. This scale has been shown to be effective in identifying such stroke patients when it is performed by a trained physician.4 It can be taught in approximately 10 minutes and
Acknowledgements
We thank the men and women of the University of Cincinnati Mobile Care Unit for their assistance in this project.
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2024, Canadian Journal of Neurological SciencesMachine learning applications in stroke medicine: Advancements, challenges, and future prospective
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Supported by the Emergency Medicine Foundation through an unrestricted grant from Genentech.
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Address for reprints:Rashmi Kothari, MD, Department of Emergency Medicine, University of Cincinnati, Post Office Box 670769, Cincinnati, OH 45267-0769; 513-558-5281, fax 513-558-5791;E-mail [email protected].
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