The FAST-ED App: A Smartphone Platform for the Field Triage of Patients With Stroke

The FAST-ED App: A Smartphone Platform for the Field Triage of Patients With Stroke

Author Nogueira, Raul G. Google Scholar
Silva, Gisele S. Autor UNIFESP Google Scholar
Lima, Fabricio O. Google Scholar
Yeh, Yu-Chih Google Scholar
Fleming, Carol Google Scholar
Branco, Daniel Google Scholar
Yancey, Arthur H. Google Scholar
Ratcliff, Jonathan J. Google Scholar
Wages, Robert Keith Google Scholar
Doss, Earnest Google Scholar
Bouslama, Mehdi Google Scholar
Grossberg, Jonathan A. Google Scholar
Haussen, Diogo C. Google Scholar
Sakano, Teppei Google Scholar
Frankel, Michael R. Google Scholar
Abstract Background and Purpose-The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. Methods-Review of the application's platform and its development as well as the different variables, assessments, algorithms, and assumptions involved. Results-The FAST-ED (Field Assessment Stroke Triage for Emergency Destination) application is based on a built-in automated decision-making algorithm that relies on (1) a brief series of questions assessing patient's age, anticoagulant usage, time last known normal, motor weakness, gaze deviation, aphasia, and hemineglect

(2) a database of all regional stroke centers according to their capability to provide endovascular treatment

and (3) Global Positioning System technology with real-time traffic information to compute the patient's eligibility for intravenous tissue-type plasminogen activator or endovascular treatment as well as the distances/transportation times to the different neighboring stroke centers in order to assist Emergency Medical Services professionals with the decision about the most suitable destination for any given patient with acute ischemic stroke. Conclusions-The FAST-ED smartphone application has great potential to improve the triage of patients with acute ischemic stroke, as it seems capable to optimize resources, reduce hospital arrivals times, and maximize the use of both intravenous tissue-type plasminogen activator and endovascular treatment ultimately leading to better clinical outcomes. Future field studies are needed to properly evaluate the impact of this tool in stroke outcomes and resource utilization.
Keywords algorithms
aphasia
emergency medicine
stroke
triage
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2017
Published in Stroke. Philadelphia, v. 48, n. 5, p. 1278-1284, 2017.
ISSN 0039-2499 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 1278-1284
Origin http://dx.doi.org/10.1161/STROKEAHA.116.016026
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000401818400034
URI https://repositorio.unifesp.br/handle/11600/54583

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