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外文期刊>Hong Kong medical journal =
>Pre-hospital stroke screening and notification of patients with reperfusion-eligible acute ischaemic stroke using modified Face Arm Speech Time test
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Pre-hospital stroke screening and notification of patients with reperfusion-eligible acute ischaemic stroke using modified Face Arm Speech Time test
Objectives: To investigate the effects of pre-hospital stroke screening and notification on reperfusion therapy for patients with acute ischaemic stroke. Methods: Pre-hospital stroke screening criteria were established based on a modified version of the Face Arm Speech Time (FAST) test. Screening was performed during ambulance transport by emergency medical service (EMS) personnel who completed a 2-hour training session on stroke screening. Temporal trends affecting acute ischaemic stroke investigation and intervention were compared before and after implementation of the pre-hospital screening. Results: From July 2018 to October 2019, 298 patients with suspected stroke were screened by EMS personnel during ambulance transport prior to hospital arrival. Of these 298 patients, 213 fulfilled the screening criteria, 166 were diagnosed with acute stroke, and 32 received reperfusion therapy. The onset-to-door time was shortened by more than 1.5 hours (100.6 min vs 197.6 min, P0.001). The door-to–computed tomography time (25.6 min vs 32.0 min, P=0.021), door-to-needle time (49.2 min vs 70.1 min, P=0.003), and door-to–groin puncture time for intra-arterial mechanical thrombectomy (126.7 min vs 168.6 min, P=0.04) were significantly shortened after implementation of the pre-hospital screening and notification, compared with historical control data of patients admitted from January 2018 to June 2018, before implementation of the screening system. Conclusion: Implementation of pre-hospital stroke screening using criteria based on a modified version of the FAST test, together with pre-arrival notification, significantly shortened the door-to-reperfusion therapy time for patients with ischaemic stroke. Pre-hospital stroke screening during ambulance transport by EMS personnel who complete a 2-hour focused training session is effective for identifying reperfusion-eligible patients with stroke.
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机译：目的：探讨急诊中风筛查和通知对急性缺血性卒中患者再灌注治疗的影响。方法：基于面部臂语音时间（快）测试的修改版本建立了医院前行程筛查标准。通过紧急医疗服务（EMS）人员在中风筛查中完成2小时培训课程的救护车运输期间进行筛选。在院前筛查之前和之后比较了影响急性缺血性卒中调查和干预的时间趋势。结果：2018年7月至2019年10月，EMS人员在医院抵达前的救护车运输期间筛查了298例疑似中风患者。在这298例患者中，213次满足筛查标准，166例被诊断患有急性卒中，32种接受再灌注治疗。开始到门的时间超过1.5小时（100.6分钟Vs 197.6 min，P <0.001）。门对上的断层扫描时间（25.6分钟与32.0分钟，P = 0.021），门到针时间（49.2 min Vs 70.1 min，P = 0.003），以及动脉内的门到腹股沟刺穿时间在进行筛选系统之前，在进行医院筛查和通知后，机械血液切除术（126.7分钟，P = 0.04）显着缩短了历史控制数据，比较筛查系统前2018年1月至2018年6月。结论：使用基于快速测试的改进版本的修改版本的标准实施前院前卒中筛查，以及预抵达前通知，显着缩短了缺血性卒中患者的再灌注治疗时间。 EMS人员在救护车运输期间，在救护车运输期间，完成了2小时的专注培训课程，可有效识别符合中风的再灌注患者。
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