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| Ambulance arrivals get faster stroke care |
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17 February 2006
Stroke patients who arrive at hospital by ambulance are more likely to receive prompt and appropriate medical care than those travelling by other transportation, the results of two studies presented at the American Stroke Association International Stroke Conference in Kissimmee, Florida, show.
"The findings are a wake up call for the public and emergency room (ER) triage staff," said Dr Yousef Mohammad, from Ohio State University in Columbus, USA. When Mohammad's team studied data from 630,402 stroke patients identified from the National Hospital Ambulatory Medical Care Survey they found that nearly half of these patients had arrived at ER by means other than an ambulance. However, arrival by ambulance was associated with a higher level of care, with 73% of ambulance arrivals undergoing diagnostic procedures such as magnetic resonance imaging, compared with around 63% of those who arrived by other means. Patients who arrived by ambulance were also more likely to be admitted to hospital and to be seen by a staff physician.
In a separate study, Dr C Ken House, of Providence Health System in Portland, and co-workers determined the predictors of stroke in patients receiving a computed tomography (CT) head scan within 25 minutes of ER arrival, as recommended by national guidelines. This recommendation was met in just 36.1% of 493 patients who arrived at one of 16 Oregon hospitals within 3 hours of stroke onset. Those who arrived in an ambulance had a higher chance of receiving a CT scan promptly than patients arriving by other means. In addition, patients who saw a neurologist, had a National Institute of Health Stroke Scale assessment, a body mass index within the normal range, and were treated at an urban hospital were more likely than other patients to receive a CT scan according to the guidelines, as were those who had commercial insurance.
Dr House stressed that it is faster and safer to travel to hospital by ambulance in the event of a stroke. "On the other hand," he said, "ER and radiology personnel must consider stroke patients a top priority and avoid delays in getting brain images - whether the patient arrives by ambulance or not."
Reference:
American Stroke Association International Stroke Conference: Kissimmee, Florida, USA; 16-18 February 2006
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