Decreasing stroke code to ct time in patients presenting with early stroke

Abdulaziz Al Luhaib

Decreasing stroke code to ct time in patients presenting with early stroke

Webinar on Emergency Medicine and Current Research

September 17, 2024 | London, UK

Abdulaziz Al Luhaib

Prince Sultan Military Medical City, Saudi Arabia

Posters & Accepted Abstracts: J Intensive and Critical Care

Abstract:

Background: The benefits of early stroke interventions are time dependent. American Heart Association set specific targets to improve the outcomes. One of these targets is door-to-CT completions of less than 25 minutes. Problem: Clinical evaluation of stroke code patients by neurology team prior to performing CT brain affects the target of door-to-CT completions time. We recognized this non-critical step as an opportunity to for quality improvement in early stroke treatment. This had been decided by the stroke code stakeholders based on recent quality measures and focused group feedback. Aim: Our aim was to decrease the door-to-CT completion time to less than 15 minutes. We hypothesized that decreasing this time would decrease the door-to-treatment time and hence the patient-oriented outcomes. Method: Setting: Prince Sultan Military Medical City is a certified stroke center with more than 3000 annual ED visits. Approximately 500 stroke code activated annually. Intervention: The patients with stroke code to be sent immediately to CT scanner without mandating neurology team evaluation in the emergency department. Measure: The time, in minutes, from code activation to CT completion. Results: The date extracted From January 2020, til January 2021, showed a great improvement with significant decrease in median time from code to CT from 25 min to 18 min ,our data from January 2020 showed of 601 stroke code activation, of whom 430 stroke or TIA with and the rest was stroke mimicker 171 patient. we implemented our intervention as a departmental policy to further decrease time to 15 minutes (our goal). Conclusion: Although the primary goal was not met, we achieved an improvement in door-to-CT completion. We believe decreasing the door-totreatment time in early stroke is multifactorial. Recognizing the steps that impede the process is essential for future improvement.