Abstract WP245: Emergency Medical System Medics' Understanding of Time Last Known Normal for Certain Strokes is Low but Can Be Significantly Improved With Education

• Published in: Stroke (1970) 2016-02, Vol.47 (suppl_1)
• Main Authors: Allen, Evan, Banerjee, Paul, Husty, Todd, Richards, Donald, Lovec, Rhonda, Wally, Megan, Morgan, Walter, Acosta, Indrani, Basignani, Cherlynn
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.47.suppl_1.wp245

Abstract only Introduction: Washington University in St. Louis research shows 53% of EMS time last normal (TLN) for wake up strokes differ by 208 minutes (mean) from Stroke Neurologists' TLN. Multiple factors contribute to this discrepancy. We hypothesized a major factor is misunderstanding differences between TLN and the time of first awareness (TFA) of symptoms communicated by patients, family and others. We hypothesized EMS understanding could be improved for TFA, TLN and other confounders by a 20 minute education module. Method: 179 EMS medics in Polk (n=87) and Seminole (n=92) counties in West Central Florida received a 20 minute lecture and 4 pre/post-test questions on 4 different stroke scenarios with potentially discordant TLN and TFA: Wake up strokes, TLN Uncertain, "Found" strokes (defined as: initially absent historian returns to find non-verbal patient with new stroke symptoms) and "waxing/waning strokes" (defined as: new symptoms BOTH fully resolve to baseline AND recur > 1 time in a 24 hour period). Instruction was 100% live for Polk EMS and 70% pre-recorded for Seminole EMS. Results: Response rates were 74% pre-test and 85% post-test. EMS Pretest comprehension was initially low, but tripled after education on Wake up, Found, and TLN Uncertain stroke scenarios (Pre: 29% vs Post: 76%, p