De Los Rios La Rosa, Felipe

Gonzalez, Ivis

Ramirez, Maygret

Ramos, Virginia

Starosciak, Amy

Strauss, Jayme

English

Scholarly Commons@Baptist Health South Florida

Baptist Health South FloridaScholarly Commons @ Baptist Health South FloridaAll Publications1-2018Effect of FAST-ED Implementation and Age onDistance Patients Travel from Scene toComprehensive Stroke CenterAmy StarosciakBaptist Health South Florida, amyst@baptisthealth.netMaygret RamirezBaptist Hospital of Miami, maygretr@baptisthealth.netVirginia RamosBaptist Hopsital of Miami, VirginiR@baptisthealth.netIvis GonzalezBaptist Hospital of Miami, IvisGo@baptisthealth.netJayme StraussBaptist Hopsital of Miami; Baptist Neuroscience Center, jaymes@baptisthealth.netSee next page for additional authorsFollow this and additional works at: https://scholarlycommons.baptisthealth.net/se-all-publicationsThis Conference Poster -- Open Access is brought to you for free and open access by Scholarly Commons @ Baptist Health South Florida. It has beenaccepted for inclusion in All Publications by an authorized administrator of Scholarly Commons @ Baptist Health South Florida. For moreinformation, please contact Carrief@baptisthealth.net.CitationStarosciak, Amy; Ramirez, Maygret; Ramos, Virginia; Gonzalez, Ivis; Strauss, Jayme; and De Los Rios La Rosa, Felipe, "Effect ofFAST-ED Implementation and Age on Distance Patients Travel from Scene to Comprehensive Stroke Center" (2018). All Publications.2880.https://scholarlycommons.baptisthealth.net/se-all-publications/2880AuthorsAmy Starosciak, Maygret Ramirez, Virginia Ramos, Ivis Gonzalez, Jayme Strauss, and Felipe De Los Rios LaRosaThis conference poster -- open access is available at Scholarly Commons @ Baptist Health South Florida:https://scholarlycommons.baptisthealth.net/se-all-publications/2880Elevating care through discoveryEffect of FAST-ED Implementation and Age on Distance Patients Travel from Scene to Comprehensive Stroke CenterAmy K. Starosciak, Ph.D., Maygret Ramirez, ARNP, Virginia Ramos, RN, Ivis C. Gonzalez, RN, Joseph M. Souchak,Camila Tocre Carrión, Jayme Strauss, MSN, RN, MBA, Felipe De Los Rios La Rosa, M.D. INTRODUCTIONThe Field Assessment Stroke Triage for EmergencyDestination (FAST-ED) is a pre-hospital screeningalgorithm developed to detect large vessel occlusion(LVO) strokes (Table below). FAST-ED was implementedby Miami-Dade Fire Rescue (MDFR) in March 2017 with agoal to bring potential LVOs directly to a ComprehensiveStroke Center (CSC) by bypassing Primary Stroke Centersand Acute Stroke Ready Hospitals. We assessed whetheruse of the FAST-ED increased the distance patientstraveled to a medical facility.METHODSData from three periods were compared: (A) Mar-Aug2017 after implementation of FAST-ED, (B) Mar-Aug 2016,the year before implementation, and (C) Sept 2016-Feb2017, just before implementation (Fig. 1). Distancetraveled in miles from scene to our CSC was obtainedfrom MDFR incident reports. Data also were brokendown by age (<80 vs. ≥80 years).RESULTS  • Using three months of data in each period, there was amarginally significant age x time interaction, but it wasnon-significant with six months of data in each period• No clear pattern for effect of sex was found using athree-factor ANOVACONCLUSIONS• The FAST-ED EMS initiative to bypass to a CSC did notlead to an increase in distance traveled by patients• This finding suggests that few patients actually arebypassing other centers• People ≥80 years traveled shorter distances overallcompared to people <80• Older populations in the county tend to live indeveloped regions near medical facilities, whereasyounger populations tend to live in newer, moreaffordable regions further from these centersDISCLOSURESThere are no financial disclosures related to this study.RESULTS• 825 acute stroke alerts were reviewed• 279 cases in Period A, 259 in Period B, 287 in Period C• A two-factor ANOVA with time period (A, B, C) and agegroup (<80, ≥80) as independent variables determinedif FAST-ED implementation and age affected how farpatients traveled via ambulance• Patients ≥80 years traveled shorter distances than those<80 years regardless of time period [F(1,5)=16.124,p<0.001] (Fig. 2)• Implementation of FAST-ED did not affect distancetraveled (Fig. 3)7.7 7.7 8.5024681012AAfter FAST-EDBOne year priorCSix months priorDistance (mi)Figure 3. Effect of Time Period on Distance TraveledFigure 1. Three comparison time periods: B, , 8.7 7.1024681012<80 Years ≥80 YearsDistance (mi)Figure 2. Effect of Age Group on Distance Traveled***M ‘16 M J S NJ ‘17 M M JA J A O D F A J AFAST-ED ImplementationSix Months PriorOne Year PriorItem Score Item ScoreArm Weakness Denial/NeglectNo drift 0 Absent 0Drift or some effort against gravity1Extinction to bilateral simultaneous stimulation in one sensory modality1No effort against gravity or no movement2Does not recognize own hand or orients only to one side of the body2Speech Changes Eye DeviationAbsent 0 Absent 0Mild to moderate 1 Partial 1Severe global aphasia or mute 2 Forced deviation 2Facial PalsyNormal or minor paralysis 0 Partial or complete paralysis 1

Effect of FAST-ED Implementation and Age on Distance Patients Travel from Scene to Comprehensive Stroke Center

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Effect of FAST-ED Implementation and Age on Distance Patients Travel from Scene to Comprehensive Stroke Center

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