Objectives To evaluate the feasibility and reliability of a self-designed Ventura Emergency Large Vessel Occlusion (ELVO) Scale performed by Emergency Medical Services (EMS). To identify, if field identification of ELVO, reduces door to groin time.
Background Endovascular treatment of stroke is now the standard of care for large vessel occlusion (LVO) stroke within 6 hours of onset. The outcomes of intra-arterial (IA) endovascular treatment are time dependent. The time from arrival to groin vary during the day time versus after hours or infield transfers compared to hospital to hospital transfers. Pre-identification of LVO from field can shorten the door to groin time by activation of Interventional Radiology (IR) team earlier. We designed a scale that can be used by EMS personnel in the field to identify ELVO or non-Emergency Large Vessel Occlusion.
Methods and analysis Ventura ELVO Scale (VES) comprise of four components: 1) Eye Deviation 2) Aphasia 3) Neglect 4) Obtundation, each component scoring either 1 or 0. The maximum score is 4 and minimum score is 0. The score of 1 or greater will be considered as ELVO positive. VES will be implemented by EMS to identify ELVO patients in the catchment area of Los Robles Hospital and Medical Center. Retrospective data will be collected from EMS, Emergency Department (ED) and IR records of participating patients. Door to groin time for intra-arterial (IA) treatment before implementation of the Ventura ELVO protocol will be compared with door to groin time after implementation of Ventura ELVO protocol. In prospective patients, EMS will measure ELVO score in the field using the VES. A positive ELVO score along with positive Cincinnati scale will prompt ELVO activation. EMS will call the neuro-interventionist who will then activate the neuro-intervention protocol at the receiving Hospital.
Implications Ventura ELVO scale can help to reduce door to groin puncture time, which can possibly improve the management and triage of stroke patients with ELVO.
Disclosures M. Taqi: None. S. Quadri: None. S. Suriya: None.
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