Evidence map›Paper›PMID 40298541›Full record

ArticlePrehospital emergency care2025

Implementation and Validation of Field Assessment Stroke Triage for Emergency Destination (FAST-ED) in a Rural EMS Region.

Luke Wohlford, Miles Kittell, Jackson Lyttleton, Jane G Morris, Timothy G Lukovits, Kate D Zimmerman, J Matthew Sholl, Thomas W Trimarco, Peter W Callas, Daniel Wolfson

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Prehospital emergency care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Luke WohlfordDepartment of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont.
Miles KittellDepartment of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont.
Jackson LyttletonDepartment of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont.
Jane G MorrisDepartment of Neurology, Tufts University School of Medicine at MaineHealth Maine Medical Center Portland, Portland, Maine.
Timothy G LukovitsDepartment of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Kate D ZimmermanDepartment of Emergency Medicine, Tufts University School of Medicine at MaineHealth Maine Medical Center Portland, Portland, Maine.ORCID 0009-0004-7673-7823
J Matthew ShollDepartment of Emergency Medicine, Tufts University School of Medicine at MaineHealth Maine Medical Center Portland, Portland, Maine.
Thomas W TrimarcoDepartment of Emergency Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Peter W CallasMedical Biostatistics, University of Vermont Larner College of Medicine, Burlington, Vermont.
Daniel WolfsonDepartment of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont.

Funding

Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted InterventionsU54GM115516 · NIGMS · MAINEHEALTH · PI CLIFFORD JAMES ROSEN · 2017 to 2026
$51.6M
NIGMS NIH HHS U54 GM115516
6 · The paper itself

Abstract

objectivesPrehospital identification of large vessel occlusion (LVO) stroke patients is crucial for timely mechanical thrombectomy (MT). The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) score effectively predicts LVOs, but its utility in rural, multi-state emergency medical services (EMS) systems remains unexplored.

methodsThis prospective cohort study included ground prehospital stroke alerts in Vermont, New Hampshire, and Maine from July 2021 to December 2022. Patients with a prehospital FAST-ED score recorded were enrolled. LVO was confirmed by CT angiography. Our primary outcome was the accuracy of LVO identification with FAST-ED scores. Secondary outcomes included the predictiveness of the prehospital FAST-ED score for Thrombectomy Capable Center (TCC) appropriateness, MT, and 30-day mortality.

resultsThis study included 370 patients. The overall LVO prevalence was 23.2% (

conclusionsThe FAST-ED score can be implemented by prehospital personnel to triage patients to a TCC when faced with options for hospital destination in a rural setting. This study supports incorporating FAST-ED scoring in rural protocols for potential diversions to TCCs. Further research should be done to better characterize the effects of prehospital diversion on time to thrombectomy, functional outcomes, and mortality.

Indexed as

Emergency Medical ServicesStrokeTriageAgedAged, 80 and overFemaleHumansMaineMaleMiddle AgedNew HampshireProspective StudiesRural PopulationThrombectomyVermont

Identifiers

PMID40298541
PMCPMC13102248

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