Optimizing EMS Pre-hospital Stroke Care: Comprehensive Review of LVO Scales, Guidelines and Triage Protocols

Tuesday, October 11, 2022

1:00 PM – 5:00 PM EDT

Location: 224H

Panelist(s)

Brijesh P. Mehta, MD

NeuroInterventional Surgeon, Director Comprehensive Stroke Program and NeuroInterventional Surgery
Memorial Neuroscience Institute
Weston, Florida
May Nour, MD, PhD

Interventional & Vascular Neurologist
UCLA Health
Los Angeles, California
Roberta Novakovic-White, MD

Professor of Radiology and Neurology
UT Southwestern Medical Center
Dallas, Texas
Kaiz S. Asif, MD

Regional Medical Director and Clinical Assistant Professor, Stroke and Neuroendovascular Surgery
University of Illinois-Chicago (UIC) and Amita Health, IL
Naperville, Illinois
KH

Kenny T. Harrell, Paramedic, Hazardous Materials Specialist, Aircraft Rescue Specialist, Mobile Stroke Unit Consultant

Firefighter/Paramedic EMS Consultant
Santa Monica Fire Department
Temecula, California

Description: Over the past decade, there have been significant advances in acute ischemic stroke care with the proven effectiveness of reperfusion therapies for large vessel occlusion (LVO). Due to the importance of time to treatment with intravenous thrombolysis and endovascular thrombectomy, optimizing stroke systems of care is critical to achieving good neurological outcomes.

EMS providers have an important role in the spectrum of stroke care. Pre-hospital management of acute stroke patients involves: 1) recognition of signs/symptoms, 2) assessment with a validated LVO scale, 3) destination triage to the most appropriate stroke center and 4) communicating pertinent stroke alert information to the receiving facility. Each of these steps requires training and education of frontline paramedics. For accountability, EMS leaders should also understand quality of care delivered at stroke centers through benchmark metrics and outcomes data.

In this workshop organized by the Society of Vascular and Interventional Neurology (SVIN), renowned stroke experts will give an overview of the latest advances in acute stroke care, provide case-based training of validated LVO scales, and present examples of EMS stroke triage protocols using recently published destination guidelines. Best practices for EMS integration with local stroke centers will be highlighted as part of a panel discussion.

Learning Objectives:

Recognize signs/symptoms of stroke and perform accurate field assessment using large vessel occlusion (LVO) scales.
Understand the differences between levels of care at Primary, Thrombectomy Capable and Comprehensive Stroke Centers.
Determine appropriate triage destination for acute stroke patients eligible for intravenous thrombolysis and/or endovascular thrombectomy based on available types of stroke centers in rural, suburban and urban regions.
Effectively communicate pertinent components of a pre-hospital EMS stroke alert to a destination stroke center.
Implement strategies to optimize stroke system of care in the community through collaboration with local neurointerventional experts by learning best practices currently utilized across the country.