Key result
Severity-based stroke triage improves guideline-compliant hospital selection and cuts scene-to-CT time by ~7 minutes.
Why the study?
Timely and accurate triage of stroke patients in rural settings remains a critical challenge, particularly for those with large vessel occlusions requiring rapid access to comprehensive stroke centers.
Does an adapted AHA Severity-Based Stroke Triage Algorithm improve destination selection and treatment times in rural suspected stroke patients?
Population
949 stroke transports (598 pre- and 351 post-intervention) in five rural Michigan counties
Comparison
Implementation of adapted AHA Severity-Based Stroke Triage Algorithm vs pre-intervention care
Design
Stepped-wedge study
Authors
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Supports rural EMS stroke triage; leaves open randomized confirmation of thrombectomy impact.
Does an adapted AHA Severity-Based Stroke Triage Algorithm improve destination selection and treatment times in rural suspected stroke patients?
A rural EMS severity-based triage protocol improved guideline-compliant destination selection and reduced time to CT imaging, though it did not significantly expedite mechanical thrombectomy.
Oostema et al. (2026) studied this question. Implementation of a severity-based triage protocol improved guideline-compliant hospital selection from 62% to 71% and decreased EMS scene arrival-to-CT times by 7 minutes (95% CI: 3–11).
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