Paramedic utilization of Vision, Aphasia, Neglect (VAN) stroke severity scale in the prehospital setting predicts emergent large vessel occlusion stroke

• DOI: 10.1136/neurintsurg-2020-016054
• Publication Date: 2020-07-01T21:22:40Z
• Authors: Lee Birnbaum; David Wampler; Arash Shadman; Mateja de Leonni ...; Michele Patterson; Emily Kidd; Jeanette Tovar; Ashley Garza; Bonnie Blanchard; Lara Slesnick; Adam Blanchette; David Miramontes
• Keywords: Stroke; Intraparenchymal hemorrhage

Background Numerous stroke severity scales have been published, but few studied with emergency medical services (EMS) in the prehospital setting. We Vision, Aphasia, Neglect (VAN) assessment scale setting for its simplicity to both teach and perform. This prospective cohort study was designed validate use efficacy of VAN within our systems care, which includes multiple comprehensive centers (CSCs) EMS agencies. Methods The performances National Institutes Health Stroke Scale (NIHSS) ≥6 presence emergent large vessel occlusion (ELVO) alone ELVO or any intracranial hemorrhage (ICH) combined were reported positive predictive value, sensitivity, negative specificity, overall accuracy. For subjects intraparenchymal hemorrhage, volume calculated based on ABC/2 formula intraventricular recorded. Results Both NIHSS significantly associated ICH using χ 2 analysis. Overall, hospital performed better than statistical measures. Of 34 cases mean±SD volumes 2.5±4.0 mL five VAN-negative 17.5±14.2 29 VAN-positive cases. Conclusions Our adds published evidence that can be effectively taught implemented agencies CSCs. In addition ELVO, such as may also serve an effective bypass tool.