Accuracy of Emergency Medical Services Dispatcher and Crew Diagnosis of Stroke in Clinical Practice.

Abstract:

BACKGROUND:Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city. METHODS AND RESULTS:Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression identified variables associated with correct EMS diagnosis. There were 709 total cases, with 400 having a discharge diagnosis of stroke or TIA. EMS crew sensitivity was 57.5% and PPV was 69.1%. EMS crew identified 80.2% of strokes with National Institutes of Health Stroke Scale (NIHSS) ≥5 and symptom duration <6 h. In a multivariable model, correct EMS crew diagnosis was positively associated with NIHSS (NIHSS 5-9, OR 2.62, 95% CI 1.41-4.89; NIHSS ≥10, OR 4.56, 95% CI 2.29-9.09) and weakness (OR 2.28, 95% CI 1.35-3.85), and negatively associated with symptom duration >270 min (OR 0.41, 95% CI 0.25-0.68). EMS dispatchers identified 90 stroke cases that the EMS crew missed. EMS dispatcher or crew identified stroke with sensitivity of 80% and PPV of 50.9%, and EMS dispatcher or crew identified 90.5% of patients with NIHSS ≥5 and symptom duration <6 h. CONCLUSION:Prehospital diagnosis of stroke has limited sensitivity, resulting in a high proportion of missed stroke cases. Dispatchers identified many strokes that EMS crews did not. Incorporating EMS dispatcher impression into regional protocols may maximize the effectiveness of hospital destination selection and pre-notification.

journal_name

Front Neurol

journal_title

Frontiers in neurology

authors

Jia J,Band R,Abboud ME,Pajerowski W,Guo M,David G,Mechem CC,Messé SR,Carr BG,Mullen MT

doi

10.3389/fneur.2017.00466

subject

Has Abstract

pub_date

2017-09-14 00:00:00

pages

466

issn

1664-2295

journal_volume

8

pub_type

杂志文章
  • Case Report: Innate Immune System Challenge Unleashes Paraneoplastic Neurological Autoimmunity.

    abstract::Paraneoplastic autoimmune neurological disorders reflect tumor-initiated immune responses against onconeural antigens. Symptoms and signs can affect the central and/or peripheral nervous systems, neuromuscular junction or muscle, and typically evolve subacutely before an underlying neoplasm is discovered. We describe ...

    journal_title:Frontiers in neurology

    pub_type:

    doi:10.3389/fneur.2020.598894

    authors: Zhu M,Ma Y,Zekeridou A,Lennon VA

    更新日期:2020-12-10 00:00:00

  • Diagnosis and Treatment of Spinal Syphilitic Gumma: A Case Report.

    abstract::Neurosyphilis, which is caused by Treponema pallidum, is a rare sexually transmitted disease involving the central nervous system (CNS). Among all the sub-categories, spinal syphilitic gumma is extremely rare. In previous literature, limited cases of spinal syphilitic gumma have been reported, most of which underwent ...

    journal_title:Frontiers in neurology

    pub_type:

    doi:10.3389/fneur.2019.01352

    authors: Cui L,Xu Z,Hou H

    更新日期:2020-01-15 00:00:00

  • Prospective Follow-up of Intramedullary Slitlike Cavities: A Consecutive Series of 48 Patients.

    abstract::Object: Predicting whether intramedullary slitlike cavity (SC) will worsen over time or remain stable is an outstanding clinical challenge. The aim of this study was to identify early features of SC (clinical and magnetic resonance imaging [MRI] findings). Methods: We prospectively included all patients referred to ou...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.00495

    authors: Faillot M,Morar S,Delphine S,El-Mendili M,Ducreux D,Parker F,Aghakhani N

    更新日期:2020-06-12 00:00:00

  • Validation of a Device for the Ambulatory Monitoring of Sleep Patterns: A Pilot Study on Parkinson's Disease.

    abstract::The development of wearable devices has increase interest in the use of ambulatory methods to detect sleep disorders more objectively than those permitted by subjective scales evaluating sleep quality, while subjects maintain their usual lifestyle. This study aims to validate an ambulatory circadian monitoring (ACM) d...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2019.00356

    authors: Madrid-Navarro CJ,Puertas Cuesta FJ,Escamilla-Sevilla F,Campos M,Ruiz Abellán F,Rol MA,Madrid JA

    更新日期:2019-04-11 00:00:00

  • Identification and Clinical Analysis of the First Nonsense Mutation in the PSEN1 Gene in a Family With Acute Encephalopathy and Retinitis Pigmentosa.

    abstract::In the present study, we investigated the genetic variation in a family with acute encephalopathy and retinitis pigmentosa. Nine of 25 people in this family underwent genetic testing. Three family members, namely, the proband and the proband's two sisters, showed symptoms resembling those of meningoencephalitis and si...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.00319

    authors: You C,Zeng W,Deng L,Lei Z,Gao X,Zhang VW,Wang Y

    更新日期:2020-05-05 00:00:00

  • Posterior Reversible Encephalopathy Syndrome: Clinical Features and Outcome.

    abstract::Background: Posterior reversible encephalopathy syndrome (PRES) is an acute neurotoxic syndrome that is characterized by a spectrum neurological and radiological feature from various risk factors. Common neurological symptoms includes headache, impairment in level of consciousness, seizures, visual disturbances, and f...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2020.00071

    authors: Hinduja A

    更新日期:2020-02-14 00:00:00

  • Non-fluent/Agrammatic Variant of Primary Progressive Aphasia With Generalized Auditory Agnosia.

    abstract::Cortical neurodegeneration-induced non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a clinical syndrome characterized by non-fluent speech, such as apraxia of speech or agrammatism. We describe the case of an 80-year-old right-handed woman who exhibited nfvPPA. Atypically, our patient also pres...

    journal_title:Frontiers in neurology

    pub_type:

    doi:10.3389/fneur.2020.00519

    authors: Watanabe H,Ikeda M,Mori E

    更新日期:2020-06-26 00:00:00

  • An Enigmatic Case of Acute Mercury Poisoning: Clinical, Immunological Findings and Platelet Function.

    abstract::Severe mercury intoxication is very rare in developed countries, but still occurs as the result of volatile substance abuse, suicide attempts, occupational hazards, or endemic food ingestion as reported in the cases of public health disasters in Iraq and in Minamata Bay, Japan. Here, we describe the dramatic physical ...

    journal_title:Frontiers in neurology

    pub_type:

    doi:10.3389/fneur.2017.00517

    authors: Kleffner I,Eichler S,Ruck T,Schüngel L,Pfeuffer S,Polzer P,Dittrich R,Dziewas R,Gross CC,Göbel K,Wiendl H,Kehrel BE,Meuth SG

    更新日期:2017-09-28 00:00:00

  • The Role of NLRP3 and IL-1β in Refractory Epilepsy Brain Injury.

    abstract::Objective: The objective of this study was to investigate the roles and mechanisms of inflammatory mediators NLRP3 and IL-1β in refractory temporal epilepsy brain injury. Method: First, the brain tissue and the peripheral blood of children undergoing intractable temporal lobe epilepsy surgery were analyzed as research...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2019.01418

    authors: Wu C,Zhang G,Chen L,Kim S,Yu J,Hu G,Chen J,Huang Y,Zheng G,Huang S

    更新日期:2020-02-07 00:00:00

  • Cranioplasty Following Decompressive Craniectomy.

    abstract::Cranioplasty (CP) after decompressive craniectomy (DC) for trauma is a neurosurgical procedure that aims to restore esthesis, improve cerebrospinal fluid (CSF) dynamics, and provide cerebral protection. In turn, this can facilitate neurological rehabilitation and potentially enhance neurological recovery. However, CP ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2019.01357

    authors: Iaccarino C,Kolias AG,Roumy LG,Fountas K,Adeleye AO

    更新日期:2020-01-29 00:00:00

  • Informed consent: the rate-limiting step in acute stroke trials.

    abstract::Successful implementation of a randomized clinical trial (RCT) for neuro-vascular emergencies such as cerebral infarction, intracerebral hemorrhage, or subarachnoid hemorrhage is extraordinarily challenging. Besides establishing an accurate, hyper-expedited diagnosis among many mimics in a person with acute neurologic...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2011.00065

    authors: Rose DZ,Kasner SE

    更新日期:2011-10-17 00:00:00

  • Microangiopathy-A Potential Contributing Factor to Idiopathic Polyneuropathy: A Mini Review.

    abstract::Chronic idiopathic axonal polyneuropathy (CIAP) is a slowly progressive predominantly sensory axonal polyneuropathy. The prevalence of CIAP increases with age. The pathogenic cause of CIAP is unknown although there are several prevailing etiological hypotheses. In this mini review, we focus on the hypothesis of distur...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2018.00043

    authors: Samuelsson K,Press R

    更新日期:2018-02-12 00:00:00

  • Cerebral Microcirculation and Histological Mapping After Severe Head Injury: A Contusion and Acceleration Experimental Model.

    abstract:Background:Cerebral microcirculation after severe head injury is heterogeneous and temporally variable. Microcirculation is dependent upon the severity of injury, and it is unclear how histology relates to cerebral regional blood flow. Objective:This study assesses the changes of cerebral microcirculation blood flow o...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2018.00277

    authors: Bellapart J,Cuthbertson K,Dunster K,Diab S,Platts DG,Raffel OC,Gabrielian L,Barnett A,Paratz J,Boots R,Fraser JF

    更新日期:2018-05-07 00:00:00

  • Centrality of Early Synaptopathy in Parkinson's Disease.

    abstract::Significant advances have been made in the understanding of the numerous mechanisms involved in Parkinson's disease (PD) pathogenesis. The identification of PD pathogenic mutations and the use of different animal models have contributed to better elucidate the processes underlying the disease. Here, we report a brief ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2018.00103

    authors: Imbriani P,Schirinzi T,Meringolo M,Mercuri NB,Pisani A

    更新日期:2018-03-01 00:00:00

  • Mobility Deficits Assessed With Mobile Technology: What Can We Learn From Brain Iron-Altered Animal Models?

    abstract::Background: Recent developments in mobile technology have enabled the investigation of human movements and mobility under natural conditions, i.e., in the home environment. Iron accumulation in the basal ganglia is deleterious in Parkinson's disease (i.e., iron accumulation with lower striatal level of dopamine). The ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2019.00833

    authors: Hopfner F,Hobert MA,Maetzler C,Hansen C,Pham MH,Moreau C,Berg D,Devos D,Maetzler W,Fair-Park II study group.

    更新日期:2019-08-08 00:00:00

  • Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis.

    abstract::Cerebral venous sinus thrombosis (CVST) is a relatively uncommon cause of stroke more often affecting women and younger individuals. Blockage of the venous outflow rapidly causes edema and space-occupying venous infarctions and it seems intuitive that decompressive craniectomy (DC) can effectively reduce intracranial ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2019.00511

    authors: Avanali R,Gopalakrishnan MS,Devi BI,Bhat DI,Shukla DP,Shanbhag NC

    更新日期:2019-05-15 00:00:00

  • Large Vessel Disease Modifies the Relationship Between Kidney Injury and Cerebral Small Vessel Disease.

    abstract::Background: Recent studies have shown that renal disease is associated with magnetic resonance imaging (MRI) markers of cerebral small vessel disease (CSVD), independent of traditional vascular risk factors. Although large artery lesions might be involved in the cerebrorenal association, evidence has been lacking. Met...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2018.00498

    authors: Ao DH,Zhai FF,Han F,Zhou LX,Ni J,Yao M,Zhang DD,Li ML,Fan XH,Jin ZY,Cui LY,Zhang SY,Zhu YC

    更新日期:2018-06-26 00:00:00

  • Aberrant Brain Activity at Early Delay Stage Post-radiotherapy as a Biomarker for Predicting Neurocognitive Dysfunction Late-Delayed in Patients With Nasopharyngeal Carcinoma.

    abstract::Background: Increasing evidence indicates that early radiation-induced subtle cerebral changes may be the precursors to permanent brain dysfunction at the late-delayed (LDS) post-radiotherapy (RT) stage. In this study, we aim to track the RT-related longitudinal brain activity in nasopharyngeal carcinoma (NPC) patient...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2019.00752

    authors: Yang Y,Lin X,Li J,Han L,Li Z,Liu S,Hou G,Xie C,Lv X,Qiu Y

    更新日期:2019-07-16 00:00:00

  • Cognitive Processing Impacts High Frequency Intracranial EEG Activity of Human Hippocampus in Patients With Pharmacoresistant Focal Epilepsy.

    abstract::The electrophysiological EEG features such as high frequency oscillations, spikes and functional connectivity are often used for delineation of epileptogenic tissue and study of the normal function of the brain. The epileptogenic activity is also known to be suppressed by cognitive processing. However, differences bet...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.578571

    authors: Cimbalnik J,Pail M,Klimes P,Travnicek V,Roman R,Vajcner A,Brazdil M

    更新日期:2020-10-27 00:00:00

  • Analysis of the Skew Deviation to Evaluate the Period of Onset of a Canalolithiasis After Macular Damage.

    abstract::Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular end-organ disease, and it is one of the first causes of access to the emergency room. The moment of migration of the otoconial debris in a semicircular canal does not necessarily coincide with the moment of detachment of the debris th...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.572531

    authors: Gufoni M,Vianini M,Casani AP

    更新日期:2020-10-23 00:00:00

  • Anti-inflammatory and Oto-Protective Effect of the Small Heat Shock Protein Alpha B-Crystallin (HspB5) in Experimental Pneumococcal Meningitis.

    abstract::Sensorineural hearing loss is the most common long-term deficit after pneumococcal meningitis (PM), occurring in up to 30% of surviving patients. The infection and the following overshooting inflammatory host response damage the vulnerable sensory cells of the inner ear, resulting in loss of hair cells and spiral gang...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2019.00570

    authors: Erni ST,Fernandes G,Buri M,Perny M,Rutten RJ,van Noort JM,Senn P,Grandgirard D,Roccio M,Leib SL

    更新日期:2019-06-10 00:00:00

  • Modulation of Reaction Times and Sense of Agency via Subliminal Priming in Functional Movement Disorders.

    abstract::Background: In functional movement disorders, explicit movements are impaired, while implicit movements are preserved. Furthermore, there is evidence that the sense of agency is abnormal. Aim: We aimed to investigate how motor responses and sense of agency were affected by subliminal or supraliminal cues in people wit...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.00989

    authors: Huys AML,Edwards MJ,Bhatia KP,Haggard P

    更新日期:2020-09-11 00:00:00

  • CSF Neurofilament Light Chain Levels in Primary Progressive MS: Signs of Axonal Neurodegeneration.

    abstract::Objectives: Elevated neurofilament light chain (NFL) levels within the cerebrospinal fluid (CSF) are a biomarker representing axonal neurodegeneration in rapid progressive neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS). It is unclear to what extent the levels of NFL increase in the CSF (CSF-NFL...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2018.01037

    authors: Pawlitzki M,Schreiber S,Bittner D,Kreipe J,Leypoldt F,Rupprecht K,Carare RO,Meuth SG,Vielhaber S,Körtvélyessy P

    更新日期:2018-12-14 00:00:00

  • MRI Characteristics of the Evolution of Supratentorial Recent Small Subcortical Infarcts.

    abstract:OBJECTIVE:Morphological changes of recent small subcortical infarcts are not well defined. The purpose of the present study was to describe the MRI characteristics of the evolution for this stroke subtype. METHODS:We conducted a retrospective review of patients diagnosed with definite supratentorial recent small subco...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2015.00118

    authors: Okazaki S,Hornberger E,Griebe M,Gass A,Hennerici MG,Szabo K

    更新日期:2015-05-26 00:00:00

  • A Cross-Study Analysis for Reproducible Sub-classification of Traumatic Brain Injury.

    abstract::Objective: To identify reproducible sub-classes of traumatic brain injury (TBI) that correlate with patient outcomes. Methods: Two TBI datasets from the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System were utilized, Transforming Research and Clinical Knowledge in Traumatic Brain Injury ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2018.00606

    authors: Si B,Dumkrieger G,Wu T,Zafonte R,Dodick DW,Schwedt TJ,Li J

    更新日期:2018-08-13 00:00:00

  • Cervical and Ocular Vestibular-Evoked Myogenic Potentials in Patients With Intracochlear Schwannomas.

    abstract::Objective: To evaluate ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs) in patients with solely intracochlear localization of an intralabyrinthine schwannoma (ILS). Study Design: Retrospective analysis of a series of cases. Setting: Monocentric study at a tertiary referral center. Patients...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.549817

    authors: Fröhlich L,Curthoys IS,Kösling S,Obrist D,Rahne T,Plontke SK

    更新日期:2020-10-27 00:00:00

  • Hemorrhagic Transformation in Ischemic Moyamoya Disease: Clinical Characteristics, Radiological Features, and Outcomes.

    abstract::Objective: Hemorrhagic transformation (HT) in ischemic moyamoya disease (MMD), reasonably defined as hemorrhage events in patients with ischemic onset manifestation, leads to a poor outcome. This study aims to reveal factors associated with HT in patients with ischemic onset manifestation and to assess the outcome of ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2020.00517

    authors: Lu J,Li Z,Zhao Y,Chen X,Shi G,Zhao J

    更新日期:2020-06-25 00:00:00

  • Brainstem Encephalitis With Low-Titer Acetylcholine Receptor Antibodies Mimicking Myasthenia Gravis.

    abstract::Objective: To report a rare case of brainstem encephalitis with low-titer acetylcholine receptor antibodies mimicking myasthenia gravis. Methods: The patient was investigated with repeated brain MRI, CSF examination, repetitive nerve stimulation, thoracic CT, and serologic screening. Our patient passed away and finall...

    journal_title:Frontiers in neurology

    pub_type:

    doi:10.3389/fneur.2019.00829

    authors: Ayzenberg I,Ellrichmann G,Schroeder C,Tönges L,Klasing A,Pappa V,Brück W,Gold R

    更新日期:2019-08-02 00:00:00

  • Gut Microbiota as a Therapeutic Target to Ameliorate the Biochemical, Neuroanatomical, and Behavioral Effects of Traumatic Brain Injuries.

    abstract::Current efficacious treatments for traumatic brain injury (TBI) are lacking. Establishment of a protective gut microbiota population offers a compelling therapeutic avenue, as brain injury induces disruptions in the composition of the gut microbiota, i.e., gut dysbiosis, which has been shown to contribute to TBI-relat...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章,评审

    doi:10.3389/fneur.2019.00875

    authors: Rice MW,Pandya JD,Shear DA

    更新日期:2019-08-16 00:00:00

  • Cluster Analysis to Identify Possible Subgroups in Tinnitus Patients.

    abstract:INTRODUCTION:In tinnitus treatment, there is a tendency to shift from a "one size fits all" to a more individual, patient-tailored approach. Insight in the heterogeneity of the tinnitus spectrum might improve the management of tinnitus patients in terms of choice of treatment and identification of patients with severe ...

    journal_title:Frontiers in neurology

    pub_type: 杂志文章

    doi:10.3389/fneur.2017.00115

    authors: van den Berge MJC,Free RH,Arnold R,de Kleine E,Hofman R,van Dijk JMC,van Dijk P

    更新日期:2017-04-03 00:00:00