Design and retrospective analysis of the Los Angeles Prehospital Stroke Screen (LAPSS).
Design and retrospective analysis of the Los Angeles Prehospital Stroke Screen (LAPSS).
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DOI：
10.1080/10903129808958878
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发表时间：
1998-10-01
期刊：
影响因子：
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通讯作者：
Starkman, S
中科院分区：
文献类型：
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作者：
Kidwell, C S;Saver, J L;Starkman, S
结论：急性脑缺血干预的治疗窗很短。急性卒中患者的院前识别和神经保护剂的护理管理可能很快成为成功治疗急性卒中的关键组成部分。这项初步研究试图证明，一种新的院前筛查工具，洛杉矶院前卒中筛查（LAPSS），敏感地识别急性卒中患者。此外，该研究评估了潜在的时间节省，可以通过护理管理的神经保护剂在field.METHODS：作者设计了一个简单的中风筛选工具，用于院前人员，强调运动缺陷。然后，他们测试仪器的性能和节省的时间回顾性，采用的数据在6个小时内的症状发作的随机中风试验在三所大学相关的护理人员接收hospital.Results：50的83名患者参加了超急性中风试验到达救护车，其中包括41缺血性梗死和7个血管闭塞。在41例急性缺血性卒中患者中，38例（93%）可被LAPSS准确识别。对于这38例患者，1小时50分钟将被保存有神经保护药物由护理人员在运输与研究药物管理在急诊科的实际时间。结论：LAPSS灵敏地识别救护车到达急性中风患者，大量的时间节省将可能发生，如果神经保护药物由护理人员在现场管理。LAPSS是一种很有前途的工具，它可以在短时间内以高度的灵敏度和简单性实现对中风的辅助识别。
OBJECTIVES: The therapeutic window for intervention in acute cerebral ischemia is brief. Prehospital identification of acute stroke patients and paramedic administration of neuroprotective agents may soon become critical components of successful acute stroke treatment. This preliminary study sought to demonstrate that a new prehospital screening instrument, the Los Angeles Prehospital Stroke Screen (LAPSS), sensitively identifies acute stroke patients. Further, the study evaluated the potential time savings that could be achieved by paramedic administration of neuroprotective agents in the field.METHODS: The authors designed a simple stroke screening tool for use by prehospital personnel, emphasizing motor deficits. They then tested instrument performance and time savings retrospectively, employing data from patients enrolled within six hours of symptom onset in randomized stroke trials at three university-associated paramedic receiving hospitals.RESULTS: Fifty of 83 patients enrolled in hyperacute stroke trials arrived by ambulance, including 41 with ischemic infarcts and seven with hemorrhages. Of the 41 with acute ischemic stroke, 38 (93%) would have been accurately identified by the LAPSS. For these 38 patients, 1 hour and 50 minutes would have been saved had neuroprotective drug been administered by paramedics at the time of transport vs the actual time of study agent administration in the emergency department.CONCLUSIONS: The LAPSS sensitively identifies ambulance-arriving acute stroke patients, and a substantial time savings will potentially occur if neuroprotective agents are administered by paramedics in the field. The LAPSS is a promising tool that may enable paramedic recognition of stroke with a high degree of sensitivity and simplicity in a short period of time.