- Title
- The Hunter-8 Scale Prehospital Triage Workflow for Identification of Large Vessel Occlusion and Brain Haemorrhage
- Creator
- Garcia-Esperon, C.; Ostman, C.; Amin, M.; Gangadharan, S.; Lillicrap, T.; Parsons, M.; Levi, C. R.; Spratt, N. J.; Walker, F. R.; Chew, B. L. A.; Edwards, S.; Emery, J.; Bendall, J.; Alanati, K.; Dunkerton, S.; de Barros, R. S.
- Relation
- Prehospital Emergency Care Vol. 27, Issue 5, p. 623-629
- Publisher Link
- http://dx.doi.org/10.1080/10903127.2022.2120134
- Publisher
- Taylor & Francis
- Resource Type
- journal article
- Date
- 2023
- Description
- Objective: The Hunter-8 prehospital stroke scale predicts large vessel occlusion in hyperacute ischemic stroke patients (LVO) at hospital admission. We wished to test its performance in the hands of paramedics as part of a prehospital triage algorithm. We aimed to determine (a) the proportion of patients identified by the Hunter-8 algorithm, receiving reperfusion therapies, (b) whether a call to stroke team improved this, and (c) performance for LVO detection using an expanded LVO definition. Methods: A prehospital workflow combining pre-morbid functional status, time from symptom onset, and the Hunter-8 scale was implemented from July 2019. A telephone call to the stroke team was prompted for potential treatment candidates. Classic LVO was defined as a proximal middle cerebral artery (MCA-M1), terminal internal carotid artery, or tandem occlusion. Extended LVO added proximal MCA-M2 and basilar occlusions. Results: From July 2019 to April 2021, there were 363 Hunter-8 activations, 320 analyzed: 181 (56.6%) had confirmed ischemic strokes, 13 (4.1%) transient ischemic attack, 91 (28.5%) stroke mimics, and 35 (10.9%) intracranial hemorrhage. Fifty-two patients (16.3%) received reperfusion therapies, 35 with Hunter-8 ≥ 8. The stroke doctor changed the final destination for 76 patients (23.7%), and five received reperfusion therapies. The AUCs for classic and extended LVO were 0.73 (95% CI 0.66–0.79) and 0.72 (95% CI 0.65–0.77), respectively. Conclusion: The Hunter-8 workflow resulted in 28.7% of confirmed ischemic stroke patients receiving reperfusion therapies, with no secondary transfers to the comprehensive stroke center. The role of communication with stroke team needs to be further explored.
- Subject
- stroke; brain haemorrhage; emergency health service; ischemic stroke; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1490338
- Identifier
- uon:52878
- Identifier
- ISSN:1090-3127
- Language
- eng
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