Acute Ischemic Stroke, Intracerebral Hemorrhage
Conditions
Keywords
computed tomography (CT) scan
Brief summary
To evaluate the feasibility of Emergency Medical System (EMS)-performed cPOCUS in the field for diagnosis of acute Intracerebral hemorrhage (ICH)
Detailed description
With the over-arching goal of achieving early diagnosis of Intracerebral hemorrhage (ICH) with cPOCUS, this study hypothesizes that (a) Emergency Medical System (EMS) personnel can competently perform cPOCUS in the field in a timely fashion in a large majority of stroke patients; (b) acquired POCUS images can be successfully and securely transmitted for a remote physician interpretation in a timely manner; and (c) cPOCUS will have a greater sensitivity and specificity than clinical scores as a screening tool for ICH identification in pre-hospital settings.
Interventions
PROCEDURECranial Point of Care Ultrasound
Cranial ultrasound involves 2-dimensional B mode imaging of the brain parenchyma in the axial plane using a 1-2 MHz probe through the thin temporal bone. Upload of cPOCUS images will occur over DICOM® based Health Insurance Portability and Accountability Act (HIPAA) compliant platforms accessible via Cloud. Currently all handheld machines use Tricefy® or their own cloud based remote image access application.
Sponsors
Wake Forest University Health Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Intervention model description
Any patient deemed to have a stroke like presentation or possibility of brain hemorrhage in the clinical judgement of the EMS provider and a decision to transfer the patient to the nearest ED for further evaluation has been made
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Any patient deemed to have a stroke like presentation or possibility of brain hemorrhage in the clinical judgement of the Emergency Medical Services (EMS) provider and a decision to transfer the patient to the nearest Emergency Department (ED) for further evaluation has been made will be eligible for the study * 18 years old or older * transfer initiated by EMS to the ED for further evaluation * performing ultrasound will not interfere with the care or triage as part of routine care
Exclusion criteria
* less than 18 years old * incarcerate patients * penetrating cranial/head trauma or scalp wound * any patient where performing ultrasound will interfere with the care * patients who decide not to be transported to ED
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Success Rate for cPOCUS Exams | Year 1 | cPOCUS will be attempted and performed on about 1000 patients over 12 months by 30 EMS providers |
Countries
United States
Outcome results
None listed