Re: Dispatcher Recognition of Stroke Using the National Academy Medical Priority Dispatch System

[Guest guest]

I'm shocked. Shocked, I tell you.

GG

>

>

>

> Background and Purpose‹ Emergency medical dispatchers play an important

> role

> in optimizing stroke care if they are able to accurately identify calls

> regarding acute cerebrovascular disease. This study was undertaken to

> assess

> the diagnostic accuracy of the current national protocol guiding

> dispatcher

> questioning of 911 callers to identify stroke (QA Guide version 11.1 of

> the

> National Academy Medical Priority Dispatch System).

>

> Methods‹ We identified all Los Angeles Fire Department paramedic

> transports

> of patients to University of California Los Angeles Medical Center during

> the 12-month period from January to December 2005 in a prospectively

> maintained database. Dispatcher-assigned Medical Priority Dispatch System

> codes for each of these patient transports were abstracted from the

> paramedic run sheets and compared to final hospital discharge diagnosis.

>

> Results‹ Among 3474 transported patients, 96 (2.8%) had a final diagnosis

> of

> stroke or transient ischemic attack. Dispatchers assigned a code of

> potential stroke to 44.8% of patients with a final discharge diagnosis of

> stroke or TIA. Dispatcher identification of stroke showed a sensitivity of

> 0.41, specificity of 0.96, positive predictive value of 0.45, and negative

> predictive value of 0.95.

>

> Conclusions‹ Dispatcher recognition of stroke calls using the widely

> employed Medical Priority Dispatch System algorithm is suboptimal, with

> failure to identify more than half of stroke patients as likely stroke.

> Revisions to the current national dispatcher structured interview and

> symptom identification algorithm for stroke may facilitate more accurate

> recognition of stroke by emergency medical dispatchers.

>

> Stroke. 2009;40:2027- Str

>

>

[Guest guest]

I'm shocked. Shocked, I tell you.

GG

>

>

>

> Background and Purpose‹ Emergency medical dispatchers play an important

> role

> in optimizing stroke care if they are able to accurately identify calls

> regarding acute cerebrovascular disease. This study was undertaken to

> assess

> the diagnostic accuracy of the current national protocol guiding

> dispatcher

> questioning of 911 callers to identify stroke (QA Guide version 11.1 of

> the

> National Academy Medical Priority Dispatch System).

>

> Methods‹ We identified all Los Angeles Fire Department paramedic

> transports

> of patients to University of California Los Angeles Medical Center during

> the 12-month period from January to December 2005 in a prospectively

> maintained database. Dispatcher-assigned Medical Priority Dispatch System

> codes for each of these patient transports were abstracted from the

> paramedic run sheets and compared to final hospital discharge diagnosis.

>

> Results‹ Among 3474 transported patients, 96 (2.8%) had a final diagnosis

> of

> stroke or transient ischemic attack. Dispatchers assigned a code of

> potential stroke to 44.8% of patients with a final discharge diagnosis of

> stroke or TIA. Dispatcher identification of stroke showed a sensitivity of

> 0.41, specificity of 0.96, positive predictive value of 0.45, and negative

> predictive value of 0.95.

>

> Conclusions‹ Dispatcher recognition of stroke calls using the widely

> employed Medical Priority Dispatch System algorithm is suboptimal, with

> failure to identify more than half of stroke patients as likely stroke.

> Revisions to the current national dispatcher structured interview and

> symptom identification algorithm for stroke may facilitate more accurate

> recognition of stroke by emergency medical dispatchers.

>

> Stroke. 2009;40:2027- Str

>

>