Paramedic - Norwegian Acute Stroke Prehospital Project

Conditions

Mobile Application, Paramedic, Stroke, Triage

Brief summary

The main aim of the study is to show that patients with suspected acute stroke met by the emergency medical service and assessed using the eSTROKE model including prehospital NIHSS and a mobile application will identify a higher number of patients with stroke, than those who receive conventional prehospital care.

Detailed description

Primary aims: In patients with suspected stroke 1. The proportion of patients hospitalized with a suspected acute stroke and discharged with a stroke diagnose is significantly increased using the ParaNASPP model compared with conventional prehospital care 2. Time from onset to hospitalization is significantly reduced with the ParaNASPP model 3. The ParaNASPP model identifies patients eligible for direct transportation for comprehensive stroke center

Helge Fagerheim Bugge, Mona Guterud, Karianne Larsen, Mathias Toft, Annette Ryen et al. (6 authors)

European Stroke Journal2026-01-01

10.1093/esj/23969873251360592

Presenting symptoms and diagnostic accuracy of prehospital stroke scales for patients with suspected mild minor stroke

Helge Fagerheim Bugge, Mona Guterud, Karianne Larsen, Mathias Toft, Maren Ranhoff Hov et al. (6 authors)

European Stroke Journal2025-08-11

10.1177/23969873251360592

Prehospital screening of acute stroke with the National Institutes of Health Stroke Scale (ParaNASPP): a stepped-wedge, cluster-randomised controlled trial.

Guterud M, Fagerheim Bugge H, Røislien J, Kramer-Johansen J, Toft M, Ihle-Hansen H, Bache KG, Larsen K, Braarud AC, Sandset EC, Ranhoff Hov M.

2023-09-0115 citations

10.1016/s1474-4422(23)00237-5

Streamlining Acute Stroke Care by Introducing National Institutes of Health Stroke Scale in the Emergency Medical Services: A Prospective Cohort Study

Karianne Larsen, Henriette S. Jæger, Maren Ranhoff Hov, Kjetil Thorsen, Volker Solyga et al. (7 authors)

Stroke2022-03-1632 citations

10.1161/strokeaha.121.036084

Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) study protocol: a stepped wedge randomised trial of stroke screening using the National Institutes of Health Stroke Scale in the ambulance.

Bugge HF, Guterud M, Bache KCG, Braarud AC, Eriksen E, Fremstad KO, Ihle-Hansen H, Ingebretsen SH, Kramer-Johansen J, Larsen K, Røislien J, Thorsen K, Toft M, Sandset EC, Hov MR.

2022-02-046 citations

10.1186/s13063-022-06006-4

Interventions

DIAGNOSTIC_TESTeSTROKE model

The eSTROKE model includes an electronic learning module, a full day course with practical teaching of National Institute of Health Stroke Scale and a mobile application which will be used for communication with in-hospital stroke physician

OTHERControl

Conventional prehospital care

Study design

Allocation

RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

DIAGNOSTIC

Masking

NONE

Intervention model description

ParaNASPP is a stepped wedge cluster randomized controlled intervention trial (SW-RCT).

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* All patients with suspected acute stroke met by emergency medical services (ambulance and rapid response car)

Design outcomes

Primary

Measure	Time frame
Positive predictive value (PPV) of the ParaNASPP model to identify patients suffering acute stroke.	On discharge from hospital - typically within 7 days.

Secondary

Measure	Time frame
Number of patients in hospitalized within the first 4 hours after symptom onset	first 4 hours On admission

Countries

Norway

Outcome results

None listed