Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States
Background Prehospital identification of large‐vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to impro...
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Wiley
2025-01-01
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| Series: | Stroke: Vascular and Interventional Neurology |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.123.001038 |
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| author | Kaiz S. Asif Robin Novakovic Thanh N. Nguyen Santiago Ortega‐Gutierrez Youngran Kim Amanda Jagolino‐Cole Sushanth Aroor Alicia Castonguay Prateek Kumar Ashutosh P. Jhadav Dileep Yavagal May Nour Gabor Toth Maxim Mokin Sunil A. Sheth Mouhammad A. Jumaa Alhamza Al‐bayati Mohamed Teleb Ossama Y. Mansour Shashvat M. Desai Joshua Hartman David S. Liebeskind Ameer E. Hassan Brijesh P. Mehta |
| author_facet | Kaiz S. Asif Robin Novakovic Thanh N. Nguyen Santiago Ortega‐Gutierrez Youngran Kim Amanda Jagolino‐Cole Sushanth Aroor Alicia Castonguay Prateek Kumar Ashutosh P. Jhadav Dileep Yavagal May Nour Gabor Toth Maxim Mokin Sunil A. Sheth Mouhammad A. Jumaa Alhamza Al‐bayati Mohamed Teleb Ossama Y. Mansour Shashvat M. Desai Joshua Hartman David S. Liebeskind Ameer E. Hassan Brijesh P. Mehta |
| author_sort | Kaiz S. Asif |
| collection | DOAJ |
| description | Background Prehospital identification of large‐vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts. Methods The Society of Vascular and Interventional Neurology, in collaboration with EMS World, created an online questionnaire for EMS personnel. It included 12 multiple‐choice and free‐response questions designed to test participants’ clinical knowledge of LVO, knowledge of stroke center certification levels, prior LVO educational experiences, preferences for educational content delivery, and perspectives on prehospital hurdles to stroke care. All subscribers of EMS World received a survey link via email. Results Of the 38 486 subscribers of EMS World, the survey email was opened by 1830, of whom 1107 completed the survey across all states in the United States, with a response rate of 2.9%. Most of the respondents identified themselves as paramedics/emergency medical technicians (91%). The number of patients with stroke that survey participants transported in the past year was <10 for 618 (56%). Only 285 (26%) participants answered both LVO knowledge questions correctly, and only 128 (12%) respondents correctly identified all types of stroke centers with thrombectomy capability. A total of 362 EMS personnel (33%) denied receiving training to perform LVO severity assessment. Respondents who received training to perform an LVO scale demonstrated nearly twice the prevalence of LVO knowledge (30.6% versus 15.7%; prevalence ratio, 1.94 [95% CI, 1.50–2.53]) than respondents who did not receive training. The top hurdle to prehospital LVO education was identified as the lack of standardized LVO training by 535 (48%) respondents. Conclusions EMS providers in the United States reported inadequate LVO training and demonstrated gaps in knowledge of LVO, stroke severity scales, and stroke center levels. Systematic efforts to enhance and standardize the educational content and delivery of LVO education are needed. |
| format | Article |
| id | doaj-art-9d99f55422134c658b064f485aede560 |
| institution | Kabale University |
| issn | 2694-5746 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-9d99f55422134c658b064f485aede5602025-01-11T08:01:41ZengWileyStroke: Vascular and Interventional Neurology2694-57462025-01-015110.1161/SVIN.123.001038Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United StatesKaiz S. Asif0Robin Novakovic1Thanh N. Nguyen2Santiago Ortega‐Gutierrez3Youngran Kim4Amanda Jagolino‐Cole5Sushanth Aroor6Alicia Castonguay7Prateek Kumar8Ashutosh P. Jhadav9Dileep Yavagal10May Nour11Gabor Toth12Maxim Mokin13Sunil A. Sheth14Mouhammad A. Jumaa15Alhamza Al‐bayati16Mohamed Teleb17Ossama Y. Mansour18Shashvat M. Desai19Joshua Hartman20David S. Liebeskind21Ameer E. Hassan22Brijesh P. Mehta23Neuro‐endovascular Section Ascension Health Chicago ILDepartments of Radiology and Neurology UT Southwestern Dallas TXNeurology Radiology Boston Medical Center Boston University Chobanian and Avedisian School of Medicine Boston MADepartment of Neurology and Radiology University of Iowa Iowa City IADepartment of Management Policy and Community Health UTHealth Houston School of Public Health Houston TXMcGovern Medical School at the University of Texas Health Sciences Center Houston TXUniversity of Toledo Toledo OHUniversity of Toledo Toledo OHDepartment of Neurology University of Illinois Hospital Chicago ILBarrow Neurological Institute Phoenix AZUniversity of Miami Miller School of Medicine Miami FLDepartments of Neurology and Radiology, University of California Los Angeles Los Angeles CACerebrovascular Center Cleveland Clinic Cleveland OHDepartment of Neurosurgery and Brain Repair University of South Florida Tampa FLDepartment of Neurology UTHealth McGovern Medical School Houston TXProMedica Neuroscience Center–University of Toledo Toledo OHUPMC Stroke Institute Department of Neurology and Neurosurgery University of Pittsburgh Pittsburgh PA USANeurointerventional Surgery Stroke and Neurocritical Care Banner Health Phoenix AZStroke and Neurointervention Center Alexandria University Alexandria EgyptHonorHealth Research and Innovation Institute Scottsdale AZEMS World HMP Malvern PAUCLA Stroke Center Los Angeles CADepartment of Neurology Valley Baptist Medical Center–University of Texas Rio Grande Valley Harlingen TXDepartment of Neurosurgery Memorial Neuroscience Institute Pembroke Pines FLBackground Prehospital identification of large‐vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts. Methods The Society of Vascular and Interventional Neurology, in collaboration with EMS World, created an online questionnaire for EMS personnel. It included 12 multiple‐choice and free‐response questions designed to test participants’ clinical knowledge of LVO, knowledge of stroke center certification levels, prior LVO educational experiences, preferences for educational content delivery, and perspectives on prehospital hurdles to stroke care. All subscribers of EMS World received a survey link via email. Results Of the 38 486 subscribers of EMS World, the survey email was opened by 1830, of whom 1107 completed the survey across all states in the United States, with a response rate of 2.9%. Most of the respondents identified themselves as paramedics/emergency medical technicians (91%). The number of patients with stroke that survey participants transported in the past year was <10 for 618 (56%). Only 285 (26%) participants answered both LVO knowledge questions correctly, and only 128 (12%) respondents correctly identified all types of stroke centers with thrombectomy capability. A total of 362 EMS personnel (33%) denied receiving training to perform LVO severity assessment. Respondents who received training to perform an LVO scale demonstrated nearly twice the prevalence of LVO knowledge (30.6% versus 15.7%; prevalence ratio, 1.94 [95% CI, 1.50–2.53]) than respondents who did not receive training. The top hurdle to prehospital LVO education was identified as the lack of standardized LVO training by 535 (48%) respondents. Conclusions EMS providers in the United States reported inadequate LVO training and demonstrated gaps in knowledge of LVO, stroke severity scales, and stroke center levels. Systematic efforts to enhance and standardize the educational content and delivery of LVO education are needed.https://www.ahajournals.org/doi/10.1161/SVIN.123.001038educationemergency medical serviceslarge‐vessel occlusionstroketraining |
| spellingShingle | Kaiz S. Asif Robin Novakovic Thanh N. Nguyen Santiago Ortega‐Gutierrez Youngran Kim Amanda Jagolino‐Cole Sushanth Aroor Alicia Castonguay Prateek Kumar Ashutosh P. Jhadav Dileep Yavagal May Nour Gabor Toth Maxim Mokin Sunil A. Sheth Mouhammad A. Jumaa Alhamza Al‐bayati Mohamed Teleb Ossama Y. Mansour Shashvat M. Desai Joshua Hartman David S. Liebeskind Ameer E. Hassan Brijesh P. Mehta Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States Stroke: Vascular and Interventional Neurology education emergency medical services large‐vessel occlusion stroke training |
| title | Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States |
| title_full | Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States |
| title_fullStr | Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States |
| title_full_unstemmed | Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States |
| title_short | Large‐Vessel Occlusion Stroke Knowledge and Training for Stroke Severity Assessment Among Emergency Medical Services Personnel in the United States |
| title_sort | large vessel occlusion stroke knowledge and training for stroke severity assessment among emergency medical services personnel in the united states |
| topic | education emergency medical services large‐vessel occlusion stroke training |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.123.001038 |
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