Abstract WP197: Stroke Center-led EMS Education Strengthens Collaborative Partnerships in Advanced Stroke Care

Background: Certified thrombectomy-capable stroke centers provide endovascular mechanical thrombectomy and post-procedural care to patients with large vessel occlusion (LVO) stroke. Partnerships in care with EMS teams are essential to connecting the community with this advanced stroke intervention. Following the revision of a New York State regional EMS stroke protocol redirecting suspected LVO patients to centers with endovascular capabilities, a thrombectomy center observed a decrease in EMS-arrived LVO patients and low use of the recommended Stratified Los Angeles Motor Score (S-LAMS), indicating a potential learning need among EMS providers related to the pre-hospital practice change. A new travel education team initiative was developed by the center to reinforce knowledge of advanced stroke systems of care practices with EMS crews at their home agencies. Methods: A rotating training team formed by stroke center neurology clinicians visited 7 agencies within 25 miles over 8 months beginning January 2024, reaching 120 volunteer and paid EMT and paramedic learners. Educational content included S-LAMS stroke assessment, pre-notification, time targets, thrombolysis, and endovascular intervention. Anonymous electronic post surveys were offered to capture crew knowledge takeaways, preferred learning styles, and ways to improve EMS experience. Stroke volume was tracked through July 2025 for changes to the downward trend in EMS-arrived LVO cases and for increased use of S-LAMS tool. Results: Of the 18% surveys returned, four feedback themes were revealed and found directly relevant to training: designations/levels of care, time, pre-notification impact on hospital workflow, and closing the loop. Stroke data review showed post-education increases in: number of thrombectomies performed, volume of direct EMS-arrived LVO patients, and documented EMS S-LAMS assessments: 2022-2023: 27 thrombectomies (56% EMS arrival; 33% S-LAMS used); 2024: 29 thrombectomies (52% EMS arrival; 80% S-LAMS used); Jan-July 2025: 19 thrombectomies (68% EMS arrival; 85% S-LAMS used). Conclusion: Stroke center-led EMS outreach championed by a travel stroke education team is an effective strategy to reinforce EMS knowledge, support collaborative partnerships, and improve consistency and alignment in advanced stroke care processes in the community. Direct engagement with EMS clinicians should be standard in stroke program educational efforts to sustain performance among pre-hospital teams.