Abstract WP287: Emergency Medical Services Providers’ Knowledge of Prehospital Stroke Care and Recommendations for Feedback

Abstract

Introduction: It has been estimated that more than 30% of all stroke cases are still missed by prehospital stroke scales and 50% or more of cases identified as stroke have been false positives. There may exist opportunities to improve the quality of prehospital stroke care by providing one-on one EMS education. The objective of this project was to provide EMS providers with one-on-one education and survey their stroke care knowledge, identify barriers to providing prenotification, and ask them about the optimal method of providing feedback. Methods: Summer students staffed four hospital emergency departments in our health system and administered a quality improvement educational survey to EMS providers over a three-month period. The survey included questions related to knowledge of prehospital stroke care and barriers to providing prenotification. Descriptive statistics were used to describe results. Results: Surveys from 301 EMS providers were analyzed. Only 33% correctly identified the time window for IV tPA administration for AIS as within 4.5 hours from the last known well time. The majority of EMS providers (83%) correctly identified the comprehensive stroke center in our health system. EMS providers reported barriers to providing prenotification, including short transport time (41%), information being lost in dispatch (40%), and not having direct communication with hospital staff (30%). Most EMS providers reported wanting to receive feedback on the stroke patients they transported (94%), and 50% reported that the optimal method of providing feedback is via a mobile application. Conclusions: Addressing deficits in prehospital stroke care knowledge among EMS providers and their barriers to providing prehospital notification are key steps to improving prehospital stroke care, and ultimately, patient outcomes. Most EMS providers desire real-time feedback via a mobile application.