Prehospital time saving: Web based smart pre-notification system of acute stroke

Abstract

Patients suspected acute stroke are critical in time delay of endovascular or intravenous thrombolytic therapy. Prehospital notification from emergency medical services (EMS) may shorten the door to recanalization time. The ‘Brain Saver’, web-based prehospital notification system could reduce the time interval from symptom onset to recanalization. Between March 2017 and February 2019 stroke team consisted of stroke specialized doctors, nurses and radiologists of multi departments received direct alarms via smart phone application from paramedics of EMS about transport information of patients with suspected stroke. We compared baseline characteristics and prehospital/ in-hospital delay time in stroke patients treated with intravenous thrombolysis or endovascular treatment for 12 months with and without EMS use Brain Saver Protocol. 167 patients (69 patients with protocol and 98 patients without protocol) were enrolled in this program. The patients who used Brain Saver had shorter median onset-to-arrival times (63 minutes versus 142 minutes, P < .001) and in in-hospital delay time (35 minutes versus 52 minutes, P < .001). Prehospital notification by Brain Saver was associated with shorter median door-to-imaging time (5 minutes versus 12 minutes, P < .001), door-to-needle time (20 minutes versus 31 minutes, P <.05), door to puncture time (55 minutes versus 137 minutes, P < .001) We found that prehospital notification was associated with faster door-to-imaging time, door-to-needle time and door-to-puncture time in patients presenting within 6 h of symptom onset. Close collaboration between stroke team in hospitals and the EMS system gives stroke suspected patients an in-time emergency care system.