Article Text

other Versions

PDF
Review
Pre-hospital detection of acute ischemic stroke secondary to emergent large vessel occlusion: lessons learned from electrocardiogram and acute myocardial infarction
  1. Alexander G Chartrain,
  2. Christopher Paul Kellner,
  3. J Mocco
  1. Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
  1. Correspondence to Dr. J Mocco, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA; j.mocco{at}mountsinai.org

Abstract

Currently, there is no device capable of detecting acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO) in the pre-hospital setting. The inability to reliably identify patients that would benefit from primary treatment with endovascular thrombectomy remains an important limitation to optimizing emergency medical services (EMS) triage models and time-to-treatment. Several clinical grading scales that rely solely on clinical examination have been proposed and have demonstrated only moderate predictive ability for ELVO. Consequently, a technology capable of detecting ELVO in the pre-hospital setting would be of great benefit. An analogous scenario existed decades ago, in which pre-hospital detection of acute myocardial infarction (AMI) was unreliable until the emergence of the 12-lead ECG and its adoption by EMS providers. This review details the implementation of pre-hospital ECG (PHECG) for the detection of AMI and explores how early experience with PHECG may be applied to ELVO detection devices, once they become available.

  • stroke
  • technology

Statistics from Altmetric.com

Footnotes

  • Contributors All authors contributed to the manuscript through manuscript composition and critical review. All authors provided final approval for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.