A/Prof. Andrew Bivard1, Dr Angela Dos-Santos, Dr Anna Balabanski, Dr Vignan Yogendrakumar, Dr Dennis Cordato, Mr Grant Hocking, Ms Skye Coote, Mr Maximilian O’Brien, Dr Sarah Edwards, Mr Mark Gibbs, Mr Allan Loudfoot, Dr Hanna Johns, Prof Leonid Churilov, Prof Stephen Davis, Prof Geoffery Donnan, Prof Mark Parsons
1Australian Stroke Alliance, Australia
2NSW Ambulance, , Australia
3Ambulance Victoria, Australia
Introduction: Stroke is the leading cause of adult disability in the developed world, and timely treatment has repeatedly been shown to be a factor in the outcome of patients. Paramedics are the first point of clinical assessment for patients with stroke-like symptoms and are an under-utilised expert resource in the race to improve patients time-to-treatment. In the Stroke Capable Ambulance project, we aim to improve the time-to-treatment of patients presenting with a stroke with a telehealth tool in selected study catchments in New South Wales and Victoria.
Methods: This is a prospective, non-randomised, cluster cross-over study of paramedic-led, process of care re-engineering trial. The intervention involves patient bypass and hospital pre-notification of suspected stroke using the Zeus stroke app. The Zeus tool supports clinical assessment scoring (mHunter-8 or ACT-FAST) and telehealth access to an neurology consultation where indicated. The intervention package also includes an enhanced clinical education on stroke assessments. We will compare process of care times between the original and re-engineered process of care. We seek to enroll 160 participants undergoing endovascular thrombectomy (EVT), 80 pre and 80 post intervention. The primary objective is to test if implementation of a paramedic-based stroke bypass model with the Zeus app-based tool for patient assessments and teleconsultation improves the time to arterial puncture for thrombectomy treatment (primary outcome) for eligible participants.
Results: The study intervention was formally commenced in December 2022 and recruitment is ongoing. A study update will be presented.
Conclusion: If positive, this study will significantly improve patient outcomes.
Biography:
Biography to come