Video Call Assisted Assessment of Acute Stroke

University of Southern Denmark (SDU)

Status: Enrolling

Conditions: Stroke; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases

Treatments: Diagnostic Test: Video call assisted assessment of acute stroke

Study type: Interventional

Funder types: Other

Identifiers

NCT06570681

SHS-Neuro-1-2024

Details and patient eligibility

About

This study aims to investigate whether a live stream video between the on-call neurologist and the emergency medical technicians can increase feasibility and performance of symptom-based prehospital stroke scales.

Full description

Treatment of stroke with either thrombolysis or thrombectomy is highly time-dependent (administration within 4.5 hours and 24 hours from symptom onset, respectively), and morbidity and mortality increase with time from symptom onset to treatment. Hence, prehospital evaluation and transport must be as accurate and rapid as possible in order to minimise time to treatment.

Different triage and transport paradigms for patients with suspected stroke are being investigated and multiple stroke scales have been coined in order to examine patients suspected of stroke in a prehospital setting. However, performance and feasibility vary greatly in different validation studies suggesting that those outcomes are greatly dependent on other factors i.e. acceptance amongst stakeholders, implementation process, patient segment etc. Some recent studies have shown promising results using video solutions between emergency medical services (EMS) personnel and on-call neurologist in examining patients suspected of stroke in the prehospital phase. The investigators will perform this trial to examine whether a video call assisted assessment of patients suspected of stroke in a prehospital setting can increase feasibility and performance of symptom-based prehospital stroke scales.

Enrollment: 512 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Suspected stroke within 24 hours from onset (confirmed with Prehospital Stroke 1 decision tool)
• Age >18 years

Exclusion criteria

• Suspected stroke more than 24 hours ago
• In-hospital stroke or private transport to hospital
• Unconsciousness defined as Glasgow Coma Score (GCS) ≤ 8 (as they cannot be rated)

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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512 participants in 2 patient groups

Standard Care

No Intervention group

Description:

If the patient is eligible for study inclusion, eight symptoms from the study protocol are evaluated and registered in the Prehospital Patient Journal (PPJ) on the amPHITM Prehospital Health Care Record (Amphi Systems, Hasserisvej 125, 9000 Aalborg, Denmark), on a tablet mounted in each EMT vehicle. If the vehicle is in the control arm the patient is triaged by the on-call neurologist based on a standard telephone call

Video call assisted assessment of acute stroke

Active Comparator group

Description:

If the patient is eligible for study inclusion, the last symptoms from the study protocol are evaluated and registered in the Prehospital Patient Journal (PPJ) on the amPHITM Prehospital Health Care Record (Amphi Systems, Hasserisvej 125, 9000 Aalborg, Denmark), on a tablet mounted in each EMT vehicle. Afterwards the EMS personnel will contact the on-call neurologist and if the vehicle is in the intervention arm a live video stream is initiated. The on-call neurologist then examines the patient via the video-call and triage the patient.

Treatment:

Diagnostic Test: Video call assisted assessment of acute stroke