For First Responders
Large Vessel Occlusion (LVO) is the new STEMI
LVO is a type of stroke where a major cerebral artery is blocked, much like how a major coronary artery is blocked with STEMI. LVO strokes have the highest rate of mortality and poor outcomes1. Thrombolytics (tPA) are the standard of care for acute ischemic stroke 但 may not work as a stand-alone treatment for LVO. Recent studies have shown that combined thrombolytics (tPA) and endovascular procedures are the most effective treatment methods1.
- 埃里克·史密斯.，以及Lee H. Schwamm. "Endovascular Clot Retrieval Therapy.“中风[1]6 (2015): 1462-1467. Broeg-Morvay, Anne, et al. "Direct Mechanical Intervention Versus Combined Intravenous and Mechanical Intervention in Large Artery Anterior Circulation Stroke.“中风[1]47.4 (2016): 1037-1044.
中风尺度
Cincinnati Prehospital Stroke Scale (CPSS) is the required stroke scale in New York State 但 consider a possible stroke severity scale that will help to identify a large vessel stroke (large vessel occlusion).
Cincinnati Prehospital Stroke Scale (CPSS) + ED = FAST-ED
- 面部下垂
- 手臂和腿的弱点
- 语言问题
+
- 眼睛偏差 -does the patient partially look to one side or do they have a forced eye deviation?
- 否认/忽视 - does the patient seem to be ignoring one side of their own body when the stimulus is applied?
Posterior circulation stroke affects around 20% of all ischemic strokes and can potentially be identified by evaluating or assessing the “Five D’s”: Dizziness, drowsiness, dysarthria, diplopia, and dysphagia. Two or more of these signs could indicate a posterior circulation stroke.
Advanced Notification
Your pre-notification call begins the stroke chain of survival. Please include the following information:
- EXACT time of onset/last known well
- CPSS/alternate stroke scale findings
- Blood Glucose value
* *如果可能的话, place two large bore IV’s for access to facilitate advanced imaging such as CT Angiogram. 也, include telephone contact information of next of kin and/or witness for additional questions/information.
What does your advanced notification do?
- Activates the stroke team
- Activates the CT scanners
- Activates pharmacy
- Prepares us for your arrival
Collaboration through Feedback and EMS Quality Group
推荐最近最火的赌博软件 strives to provide quality feedback to each EMS agency on a consistent basis. Feedback for all patients brought to 推荐最近最火的赌博软件 as a stroke or presumptive stroke will be delivered to agency representatives. Please see your agency quality director for specific feedback on patient treatment, diagnosis and discharge disposition, pre-notification call rates, and quality of the pre-notification calls.In addition to timely feedback, 推荐最近最火的赌博软件 has formed a regional EMS Quality group. Our group meets monthly to discuss pertinent topics, as they relate to pre-hospital stroke care, 在实时. Group members from Central and Northern New York are able to bring topics and cases up for discussion in a nearly concurrent manner. The group has been able to identify and address important topics such as:
- Documentation of the pre-notification call
- What information to include in this call
- Assessing for Large Vessel Occlusive strokes
- Assessing for atypical stroke signs
- IV size and placement
This workgroup will disseminate this information to our providers, impacting pre-hospital stroke care at the regional level. Download the brochure, EMS和STROKE, inspired by this group, highlighting this information.
Training Opportunities
联系 Josh Onyan, Stroke Program Manager at [email protected] for agency training opportunities.