{"title":"Large Vessel Occlusion Stroke Detection in the Prehospital Environment.","authors":"Lauren Patrick, Wade Smith, Kevin J Keenan","doi":"10.1007/s40138-021-00234-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.</p><p><strong>Recent findings: </strong>Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients.</p><p><strong>Summary: </strong>The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.</p>","PeriodicalId":43451,"journal":{"name":"Current Emergency and Hospital Medicine Reports","volume":"9 3","pages":"64-72"},"PeriodicalIF":1.4000,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s40138-021-00234-9","citationCount":"7","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Emergency and Hospital Medicine Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40138-021-00234-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/6/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 7
Abstract
Purpose of review: Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.
Recent findings: Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients.
Summary: The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.
期刊介绍:
This journal aims to offer expert review articles on the most significant recent developments in emergency and hospital medicine, with particular emphasis on the transition of patient care from the emergency department to the hospitalist service. By providing clear, insightful, balanced contributions, the journal intends to serve 1) those who provide immediate medical attention to patients with acute injuries or conditions in emergency departments and emergency medical service settings, and 2) hospitalists who deliver comprehensive medical care in collaboration with physicians and other health care personnel responsible for hospitalized patients. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include acute coronary syndrome; chronic obstructive pulmonary disease; community-acquired infections; diabetes and metabolic disease; heart failure; hospital-acquired infections; pharmacology of acute care; shared practice and economic issues; and thrombosis.