COVID-19-Related Project Enhancement
Pre-hospital provider response and management of stroke patients has been affected by COVID-19. In addition, stroke patient behavior appears to have changed and perhaps affected the number and severity level of stroke patients. Finally, how COVID-19 infection affects stroke patients is not yet understood.
In the enhancement to this project, the team will look pre- and post-COVID to: 1) evaluate how changes in data collection (in person versus remote) affect 90-day functional outcome measurement after hospital discharge; 2) assess ramifications of the nationwide observation that patient stroke calls have dropped; 3) examine the effect of EMS and hospitals’ ER protocol changes upon a range of variables including time from 911 alert to treatment and ER arrival pre and post COVID.
Enhancement Award Amount: $213,743
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
A stroke happens when blood flow doesn’t reach the brain. Strokes can cause serious disability or death. But if strokes are treated quickly, patients may have a better recovery.
Getting patients to the hospital to test for a stroke can take time. In this study, the research team is comparing two ways to test for and treat stroke. One way is in the hospital as usual. The other way is to use mobile stroke units, which are ambulances that have special equipment and health care providers who can diagnose and treat stroke on the spot.
Who can this research help?
Directors of hospitals, fire departments, and emergency medical services can use results from this research when considering how to improve care for stroke.
What is the research team doing?
In Houston, Denver, and Memphis, the research team is setting up mobile stroke units. These ambulances carry a CT scanner and lab equipment that can help diagnose strokes. A stroke team with a neurologist, nurse, CT technician, and emergency medical technician ride in the ambulance. When someone calls 911 about a possible stroke, the stroke team goes to the patient.
First, the stroke team assesses whether the patient might be having a stroke. If a stroke seems likely, the stroke team evaluates the patient with the CT scanner and other tests. The neurologist sends the CT images to the hospital for later use. The stroke team provides treatment right away for patients who have had a stroke and takes all patients to the hospital for care.
During the study, the stroke team is responding to about 6,000 possible strokes across the three cities. The team is alternating providing either mobile stroke service or regular emergency care for people with possible stroke week-by-week until the middle of 2019.
Three months after patients in the study get treatment, the research team is following up to see how a stroke affected each patient’s health.
Emergency medical service providers and companies that make equipment to diagnose stroke are working with the research team to design the ambulances and plan the study. The research team is working with patients who have had a stroke to identify what treatment results to measure.
Research methods at a glance
Other Health Services Interventions
Training and Education Interventions
Improving Healthcare Systems
- James McIngvale, CEO, Gallery Furniture
- Elizabeth McIngvale-Cegelski, PhD, Assistant Professor, Baylor University
- Debra Godbold
Other Stakeholder Partners
- Dr. David E. Persse, City of Houston, Emergency Medical Services Physician Director
- Laura Richardson, CEO, Frazer, Ltd.