Stroke Prenotification

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joeDO2

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ACEP News...
"When emergency medical services personnel alert hospitals of incoming stroke patients, evaluation and treatment are improved, but prenotification occurs in only about two-thirds of cases, according to findings from two new American Heart Association/American Stroke Association (AHA/ASA) studies."

Really? Why is this not happening for every patient?
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joeDO2 said:
ACEP News...
"When emergency medical services personnel alert hospitals of incoming stroke patients, evaluation and treatment are improved, but prenotification occurs in only about two-thirds of cases, according to findings from two new American Heart Association/American Stroke Association (AHA/ASA) studies."

Really? Why is this not happening for every patient?
Click to expand...

My guess would be lack of recognition. Doesn't the Cincinnati and LA Stroke scales only catch about 2/3 of CVAs? Those are the two screens I see taught most often.
 
joeDO2 said:
ACEP News...
"When emergency medical services personnel alert hospitals of incoming stroke patients, evaluation and treatment are improved, but prenotification occurs in only about two-thirds of cases, according to findings from two new American Heart Association/American Stroke Association (AHA/ASA) studies."

Really? Why is this not happening for every patient?
Click to expand...

Great question!

I gave the ER a courtesy notification in on EVERY pt, BLS or ALS.

Simple solution
 
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Only designated stroke centers will ask for/require pre arrival notification. That's so they can clear a bed and the CT scanner to make their required door to scan time. If they're not a stroke center they won't have a procedure for clearing the table other than calling the tech and asking for a stat. This is the difference between a stroke center and a non-stroke center.

Lets also remember that the whole pre notification and bustle of activity at arrival is exciting for EMS but annoying for the ER and it all boils down to giving TPA or not which is at best a controversial therapy. The whole stroke center system exists because TPA is a very expensive drug in search of a market and because stroke patients are disproportionately insured.
 
docB said:
Only designated stroke centers will ask for/require pre arrival notification. That's so they can clear a bed and the CT scanner to make their required door to scan time. If they're not a stroke center they won't have a procedure for clearing the table other than calling the tech and asking for a stat. This is the difference between a stroke center and a non-stroke center.

Lets also remember that the whole pre notification and bustle of activity at arrival is exciting for EMS but annoying for the ER and it all boils down to giving TPA or not which is at best a controversial therapy. The whole stroke center system exists because TPA is a very expensive drug in search of a market and because stroke patients are disproportionately insured.
Click to expand...

Conspiracy???
 
atkinsje said:
My guess would be lack of recognition. Doesn't the Cincinnati and LA Stroke scales only catch about 2/3 of CVAs? Those are the two screens I see taught most often.
Click to expand...

The MEND exam is supposed to catch a few more.

If you guys haven't done the new ASLS class yet, I'd definitely recommend it. It wasn't a significant amount of NEW information, but it was a fantastic way of putting it all together. There was the MEND examination, which is essentially an expanded version of the Cincinnati Stroke Exam.

Anyhow, go take it, great class.
 
docB said:
Lets also remember that the whole pre notification and bustle of activity at arrival is exciting for EMS but annoying for the ER and it all boils down to giving TPA or not which is at best a controversial therapy. The whole stroke center system exists because TPA is a very expensive drug in search of a market and because stroke patients are disproportionately insured.
Click to expand...

It explains why everyone wants to be a stroke center and no one wants to be a psych center or a teenage OB center.
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This.

:thumbup:
 
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