Abstract TP52: Reducing Door-to-Imaging Times in Acute Stroke Patients Presenting to the Emergency Department by Private Vehicle: Triage Hallway versus Room Evaluation

Abstract

Background: Delays in IV thrombolytic and thrombectomy treatments are associated with worse outcomes after ischemic stroke. The objective of our study was to compare door-to-CT imaging times among Code Stroke patients who presented by private vehicle and were evaluated by a physician in the emergency department (ED) either in the triage hallway or the emergency department room. Methods: We prospectively collected real-time data on Code Stroke patients presenting by private vehicle to a primary stroke center from May 1, 2022 through September 18, 2022. A Code Stroke was activated for all patients presenting to the emergency room with positive BE-FAST symptoms occurring within 24 hours from last known normal time. Patients were evaluated by a physician either in the triage hallway or an ED room prior to CT imaging. We compared baseline demographic data, NIHSS scores and door-to-CT times in patients evaluated by the physician in the ED triage hallway versus the ED room. Results: Of 55 patients who presented to the ED by private vehicle during the study period, the mean age was 54 ± 15 years, 53% were female and 45% non-white. The median NIHSS score was 1 [IQR 0-4]. There were 27 (49%) patients who underwent physician evaluation in the triage hallway and the remaining went into a patient room before going to CT. The median NIHSS scores for evaluations in the room were higher than in the triage hallway (2 vs 0, p=0.037). Overall, median time from door-to-CT was 11 minutes for patients who went directly from the triage hallway to CT and 21 minutes for patients who were roomed prior to CT (p=0.005). Conclusions: This study found that Code Stroke patients presenting by private vehicle and evaluated by an emergency physician in the triage hallway saved 10 minutes in door-to-CT time compared with physician evaluation in a room.