ReviewThe western journal of emergency medicine2016
Acute Stroke: Current Evidence-based Recommendations for Prehospital Care.
Review in The western journal of emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization.International journal of stroke : official journal of the International Stroke Society · 2023Pooled it
- Quality of stroke guidelines in low- and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2021Pooled it
- Adult Patients with Respiratory Distress: Current Evidence-based Recommendations for Prehospital Care.The western journal of emergency medicine · 2020Guideline
- Prehospital Use of Lights and Sirens in Stroke Is Associated With Faster Door-to-CT Times but Not Door-to-Thrombolysis or Door-to-Endovascular Therapy Times.Journal of the American College of Emergency Physicians open · 2026Article
- Low-flow oxygen delivery in patients with disturbed consciousness.Surgical neurology international · 2026Article
- Updated Protocol for Stroke Code Management in Prehospital Settings: The Iranian Comprehensive Stroke Code Management Program (ICSCM Phase II).Archives of academic emergency medicine · 2025Article
- Evaluating the Usability of a Remote Ischemic Conditioning Device for Pre-Hospital Stroke Management: Insights from Paramedic Simulations.Neurology international · 2024Article
- Identification of Specific Recommendations for Prehospital Stroke Care Associated with Shorter Door-to-CT Times - an analysis of Get with the Guidelines-Stroke registry and prehospital data.Frontiers in stroke · 2024Article
- Emergency Medical Services Stroke Care Performance Variability in Michigan: Analysis of a Statewide Linked Stroke Registry.Journal of the American Heart Association · 2023Article
- A comparative study on specialized services in pre-hospital emergencies in Iran and selected countries.Journal of education and health promotion · 2023Review
- Analysis of Stroke Care Among 2019-2020 National Emergency Medical Services Information System Encounters.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Human vs. Machine Learning Based Detection of Facial Weakness Using Video Analysis.Frontiers in neurology · 2022Article
- Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand.International journal of emergency medicine · 2021Article
- Potential accuracy of prehospital NIHSS-based triage for selection of candidates for acute endovascular stroke therapy.Journal of the American College of Emergency Physicians open · 2021Article
- Prehospital supplemental oxygen for acute stroke - A retrospective analysis.The American journal of emergency medicine · 2020Article
- Pediatric respiratory distress: California out-of-hospital protocols and evidence-based recommendations.Journal of the American College of Emergency Physicians open · 2020Article
- A Decision Support Method for Prehospital Emergency Care Based on Ranking the Importance of Physiological Variables.Healthcare (Basel, Switzerland) · 2020Article
- The role of the Cincinnati Prehospital Stroke Scale in the emergency department: evidence from a systematic review and meta-analysis.Open access emergency medicine : OAEM · 2019Article
- Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.The western journal of emergency medicine · 2018Review
- Variations in Cardiac Arrest Regionalization in California.The western journal of emergency medicine · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with a suspected stroke and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California.
methodsWe performed a literature review of the current evidence in the prehospital treatment of a patient with a suspected stroke and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the stroke protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were the use of a stroke scale, blood glucose evaluation, use of supplemental oxygen, patient positioning, 12-lead electrocardiogram (ECG) and cardiac monitoring, fluid assessment and intravenous access, and stroke regionalization.
resultsProtocols across EMS agencies in California varied widely. Most used some sort of stroke scale with the majority using the Cincinnati Prehospital Stroke Scale (CPSS). All recommended the evaluation of blood glucose with the level for action ranging from 60 to 80 mg/dL. Cardiac monitoring was recommended in 58% and 33% recommended an ECG. More than half required the direct transport to a primary stroke center and 88% recommended hospital notification.
conclusionProtocols for a patient with a suspected stroke vary widely across the state of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.
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