Abstract WP460: Stroke Awareness is a 911: Stroke Team and EMS Collaboration for Stroke Education

Abstract

Background: Accurate pre-hospital recognition of acute stroke is essential, but current training of EMS providers varies across agencies. We created targeted classes specifically for prehospital providers to increase their knowledge of stroke symptoms, emphasizing posterior circulating artery stroke (PCA) symptoms, with the goal to increase awareness of neurological emergencies and enhance patient destination decisions. Purpose: To enhance prehospital providers’ stroke knowledge, improve provider confidence levels of symptom identification and to help guide the prehospital providers with their stroke patient destination decision-making. Implementation process: Our stroke team collaborated with Beverly Hills Fire Department (BHFD). We created three educational modules using recorded stroke-specific paramedic calls that involved BHFD paramedics and Cedars-Sinai Mobile Intensive Care nurses. 77 EMS providers total attended the three classes. Each educational module outlined pathophysiology of stroke and reviewed treatment provided and final disposition of each case. Pre- and post-class knowledge assessment and evaluation Likert-scale surveys were distributed to each class participant. These surveys were collected and tallied. Results: Of 63 pre-class survey respondents, 25% felt definitely adequately trained and 54% felt somewhat adequately trained to recognize an acute ischemic neurologic event and felt somewhat likely to designate a patient as a Stroke Center candidate if their chief complaints coincided with PCA symptoms. Of 40 post-class survey respondents, 75% indicated that the class definitely augmented their previous training in recognizing an acute ischemic neurologic event, and 83% would very likely designate a patient as a Stroke Center candidate if their chief complaints coincided with PCA symptoms. Using Chi-square analysis, the improvement is stroke symptom confidence was statistically significant (p<0.01). Conclusions: The post-class surveys showed a substantial and statistically significant increase in the confidence levels of recognizing PCA symptoms in the field. Further studies will measure persistence of knowledge gained over time and extension of the educational modules to other agencies.