Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais

Abstract Background Stroke management require rapid identification, assessment, and transport of patients to qualified health care centers. However, there is little description in the literature on the multiple challenges associated with the pre-hospital transport of suspected stroke patients. Objective To characterize the pre-hospital care provided to suspected stroke patients by the Brazilian Emergency Medical Service (SAMU in Portuguese), by means of a descriptive case study. Methods This is a descriptive study of a series of cases. Data from the SAMU regarding the responses to emergency calls from suspected stroke patients were collected. Independent reviewers confirmed the diagnostic hypothesis and all discordances were assessed using kappa statistics. Clinical data and transport times were described as frequency and proportion or central tendency and dispersion measures. Normality of continuous variable distribution was assessed using the Kolmogorov-Smirnov test. The Mann-Whitney U test was used for comparison of medians, with a 5% significance level. Results During the studied period, 556 suspected stroke patients were treated. The kappa index was 0.82 (95% CI 0.737 to 0.919) CI. In 74.7% of the cases, the symptom onset time was not recorded. The median time elapsed between the call for emergency services and the ambulance arrival was 18 minutes, and the median transport time was 38 minutes. A total of 34% of the patients were taken to referral hospitals for stroke. Conclusion This study revealed a low level of knowledge regarding the need to determine the exact time of symptom onset of suspected stroke patients. Also, the study showed the low rate of patients taken to referral hospitals. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

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Main Authors: Gusmão,Lorenn Lages, Nascimento,Israel Junior Borges do, Rocha,Gabriel Almeida Silqueira, Oliveira,João Antonio de Queiroz, Machado,Geisiane Sousa Braga, Antunes,Izabella de Oliveira, Sant’anna,Romeu Vale, Fernandes,Breno Franco Silveira, Correia,Ubiratam Lopes, Ribeiro,Antonio Luiz Pinho, Marcolino,Milena S.
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Cardiologia 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000300245
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spelling oai:scielo:S2359-564720210003002452022-02-02Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas GeraisGusmão,Lorenn LagesNascimento,Israel Junior Borges doRocha,Gabriel Almeida SilqueiraOliveira,João Antonio de QueirozMachado,Geisiane Sousa BragaAntunes,Izabella de OliveiraSant’anna,Romeu ValeFernandes,Breno Franco SilveiraCorreia,Ubiratam LopesRibeiro,Antonio Luiz PinhoMarcolino,Milena S. Epidemiology Stroke Preventive Health Services Health Programs and Plans Public Health Health Policy Abstract Background Stroke management require rapid identification, assessment, and transport of patients to qualified health care centers. However, there is little description in the literature on the multiple challenges associated with the pre-hospital transport of suspected stroke patients. Objective To characterize the pre-hospital care provided to suspected stroke patients by the Brazilian Emergency Medical Service (SAMU in Portuguese), by means of a descriptive case study. Methods This is a descriptive study of a series of cases. Data from the SAMU regarding the responses to emergency calls from suspected stroke patients were collected. Independent reviewers confirmed the diagnostic hypothesis and all discordances were assessed using kappa statistics. Clinical data and transport times were described as frequency and proportion or central tendency and dispersion measures. Normality of continuous variable distribution was assessed using the Kolmogorov-Smirnov test. The Mann-Whitney U test was used for comparison of medians, with a 5% significance level. Results During the studied period, 556 suspected stroke patients were treated. The kappa index was 0.82 (95% CI 0.737 to 0.919) CI. In 74.7% of the cases, the symptom onset time was not recorded. The median time elapsed between the call for emergency services and the ambulance arrival was 18 minutes, and the median transport time was 38 minutes. A total of 34% of the patients were taken to referral hospitals for stroke. Conclusion This study revealed a low level of knowledge regarding the need to determine the exact time of symptom onset of suspected stroke patients. Also, the study showed the low rate of patients taken to referral hospitals. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)info:eu-repo/semantics/openAccessSociedade Brasileira de CardiologiaInternational Journal of Cardiovascular Sciences v.34 n.3 20212021-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000300245en10.36660/ijcs.20190199
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language English
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author Gusmão,Lorenn Lages
Nascimento,Israel Junior Borges do
Rocha,Gabriel Almeida Silqueira
Oliveira,João Antonio de Queiroz
Machado,Geisiane Sousa Braga
Antunes,Izabella de Oliveira
Sant’anna,Romeu Vale
Fernandes,Breno Franco Silveira
Correia,Ubiratam Lopes
Ribeiro,Antonio Luiz Pinho
Marcolino,Milena S.
spellingShingle Gusmão,Lorenn Lages
Nascimento,Israel Junior Borges do
Rocha,Gabriel Almeida Silqueira
Oliveira,João Antonio de Queiroz
Machado,Geisiane Sousa Braga
Antunes,Izabella de Oliveira
Sant’anna,Romeu Vale
Fernandes,Breno Franco Silveira
Correia,Ubiratam Lopes
Ribeiro,Antonio Luiz Pinho
Marcolino,Milena S.
Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
author_facet Gusmão,Lorenn Lages
Nascimento,Israel Junior Borges do
Rocha,Gabriel Almeida Silqueira
Oliveira,João Antonio de Queiroz
Machado,Geisiane Sousa Braga
Antunes,Izabella de Oliveira
Sant’anna,Romeu Vale
Fernandes,Breno Franco Silveira
Correia,Ubiratam Lopes
Ribeiro,Antonio Luiz Pinho
Marcolino,Milena S.
author_sort Gusmão,Lorenn Lages
title Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
title_short Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
title_full Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
title_fullStr Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
title_full_unstemmed Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
title_sort pre-hospital care for suspected stroke patients, cared for by mobile emergency care units in northern minas gerais
description Abstract Background Stroke management require rapid identification, assessment, and transport of patients to qualified health care centers. However, there is little description in the literature on the multiple challenges associated with the pre-hospital transport of suspected stroke patients. Objective To characterize the pre-hospital care provided to suspected stroke patients by the Brazilian Emergency Medical Service (SAMU in Portuguese), by means of a descriptive case study. Methods This is a descriptive study of a series of cases. Data from the SAMU regarding the responses to emergency calls from suspected stroke patients were collected. Independent reviewers confirmed the diagnostic hypothesis and all discordances were assessed using kappa statistics. Clinical data and transport times were described as frequency and proportion or central tendency and dispersion measures. Normality of continuous variable distribution was assessed using the Kolmogorov-Smirnov test. The Mann-Whitney U test was used for comparison of medians, with a 5% significance level. Results During the studied period, 556 suspected stroke patients were treated. The kappa index was 0.82 (95% CI 0.737 to 0.919) CI. In 74.7% of the cases, the symptom onset time was not recorded. The median time elapsed between the call for emergency services and the ambulance arrival was 18 minutes, and the median transport time was 38 minutes. A total of 34% of the patients were taken to referral hospitals for stroke. Conclusion This study revealed a low level of knowledge regarding the need to determine the exact time of symptom onset of suspected stroke patients. Also, the study showed the low rate of patients taken to referral hospitals. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)
publisher Sociedade Brasileira de Cardiologia
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000300245
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