Pre-hospital ct diagnosis of subarachnoid hemorrhage

Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagn...

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Bibliographic Details
Published in:Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2017-02, Vol.25 (1), p.21-21, Article 21
Main Authors: Hov, Maren Ranhoff, Ryen, Annette, Finsnes, Katrine, Storflor, Janne, Lindner, Thomas, Gleditsch, Jostein, Lund, Christian Georg
Format: Article
Language:English
Subjects:
Aged
Analgesics
Antiemetics
Case Report
Consent
Data collection
Emergency medical care
Female
Glasgow Coma Scale
Headaches
Hemorrhage
Humans
Intracranial pressure
Male
Medical diagnosis
Medical imaging
Middle Aged
Mobile Health Units
Mortality
Norway
Paramedics
Patients
Retrospective Studies
Rural areas
Stroke
Subarachnoid Hemorrhage - diagnostic imaging
Teleradiology
Tomography, X-Ray Computed
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Summary:Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT). The MSU was operated on-call from the local dispatch center in a rural area 45-160 km away from a neurosurgical department. Two patients presented with clinical symptoms and signs compatible with SAH. In both cases, the CT examination confirmed the diagnosis of SAH. Both were transported directly from patient location to the regional neurosurgical department, saving at least 2-2.5 h of pre-neurosurgical time. The Norwegian MSU model staffed with anesthesiologists can rapidly establish an exact diagnosis of SAH, which in a rural area significantly reduces time to neurosurgical care. Study data are retrospectively registered in ClinicalTrail.gov. NCT03036020 Unique Protocol ID: NASPP-2 Brief Title: The Norwegian Acute Stroke Prehospital Project Overall Status: Completed Primary Completion Date: January 2016 [Actual] Verification Date: January 2017.
ISSN:1757-7241
1757-7241
DOI:10.1186/s13049-017-0365-1