Opinion EDITORIAL Triage Based on Preclinical Scores—Low-Cost Strategy for Accelerating Time to Thrombectomy Anne W. Alexandrov, PhD, AGACNP-BC, ANVP-BC, NVRN-BC, CCRN; Klaus Fassbender, MD Current guidelines state that patients who experienced a stroke mented these prehospital LVO scales to varying degrees as part should usually be transferred to the nearest stroke-treating hos- of their EMS policy for triage decision-making. For example, the LAMS is used in the federal states of Saarland, Germany, pital. In accordance with these guidelines, most patients with 9 10 large-vessel occlusion (LVO) and Rhode Island as well as in Moscow, Russia, whereas the 7 11 are transported to a primary RACE Scale is used in Toledo, Ohio, Catalonia, Spain, and Related article page 691 stroke center (PSC) that does Texas. not offer thrombectomy. In this issue of JAMA Neurology, a study by Mazya and From there, these patients must undergo a secondary inter- colleagues examined the effects of a protocol implemented hospital transport to a thrombectomy-capable comprehen- in October 2017 in a region around Stockholm, Sweden, fo- sive stroke center (CSC). Such secondary transfers cause con- cusing on screening for LVO with a preclinical scale, their siderable treatment delays, ranging from 96 to 111 minutes.
JAMA Neurology – American Medical Association
Published: Jun 6, 2020