Abstract
Introduction
Prehospital stroke care focusses on recognition and rapid transport to specialist care as emergency treatment is time dependent. UK ambulance on-scene times (OST) with stroke patients have increased in recent years despite no major change in practice.
A literature review, clinical data and paramedic interviews identified advanced assessments (anything beyond FAST), intravenous cannulation and electrocardiograms as behaviours that extended OST. A training package was developed aimed at decreasing ambulance OST by reducing the three behaviours which was delivered to an English regional ambulance service via e-learning.
Methods
A service evaluation using routinely collected data compared targeted behaviours and OST pre, during and post training to assess impact.
Results
Data were analysed on 6,606 suspected stroke patients, (n=2,305) pre-training 01/12/21 to 13/04/22, (2,052) during-training 14/04/22 to 14/08/22 and (n=2,249) post-training 15/08/22 to 31/12/22.
The % of patients getting an ECG reduced from 49% to 38% (p value XXX), being cannulated reduced from 27% to 23% (p value XXX) and having advanced assessments went from 2% to 3% (p value XXX). The median OST reduced from 34 (IQR 25-44) minutes pre-training to 33 (25-42) minutes post training (p value <0.001).
Conclusions
Two out of three targeted behaviours were significantly reduced although the overall impact on median OST was small. Whilst the impact of the training was small these results need to considered in the context of national OST trends and confounders such as the introduction of telemedicine, industrial action and severe system-wide pressures in the post-training phase which may have offset any positive impact.
Prehospital stroke care focusses on recognition and rapid transport to specialist care as emergency treatment is time dependent. UK ambulance on-scene times (OST) with stroke patients have increased in recent years despite no major change in practice.
A literature review, clinical data and paramedic interviews identified advanced assessments (anything beyond FAST), intravenous cannulation and electrocardiograms as behaviours that extended OST. A training package was developed aimed at decreasing ambulance OST by reducing the three behaviours which was delivered to an English regional ambulance service via e-learning.
Methods
A service evaluation using routinely collected data compared targeted behaviours and OST pre, during and post training to assess impact.
Results
Data were analysed on 6,606 suspected stroke patients, (n=2,305) pre-training 01/12/21 to 13/04/22, (2,052) during-training 14/04/22 to 14/08/22 and (n=2,249) post-training 15/08/22 to 31/12/22.
The % of patients getting an ECG reduced from 49% to 38% (p value XXX), being cannulated reduced from 27% to 23% (p value XXX) and having advanced assessments went from 2% to 3% (p value XXX). The median OST reduced from 34 (IQR 25-44) minutes pre-training to 33 (25-42) minutes post training (p value <0.001).
Conclusions
Two out of three targeted behaviours were significantly reduced although the overall impact on median OST was small. Whilst the impact of the training was small these results need to considered in the context of national OST trends and confounders such as the introduction of telemedicine, industrial action and severe system-wide pressures in the post-training phase which may have offset any positive impact.
| Original language | English |
|---|---|
| Number of pages | 1 |
| Publication status | Unpublished - 4 Dec 2023 |
| Event | UK Stroke Forum 2023 - ICC, Birmingham, United Kingdom Duration: 4 Dec 2023 → 6 Dec 2023 |
Conference
| Conference | UK Stroke Forum 2023 |
|---|---|
| Abbreviated title | UKSF |
| Country/Territory | United Kingdom |
| City | Birmingham |
| Period | 4/12/23 → 6/12/23 |
