Triage assessments and the activation of rapid care protocols for acute stroke patients.

Abstract

Background: Rapid care protocols to reduce in-hospital time in the evaluation for stroke thrombolysis are now common in Emergency Departments (ED). Correct triage identification and prioritization is vital to this process. Aim(s): We set out to examine stroke triage assessments and investigate factors associated with triage category 1 or 2 allocated to stroke patients presenting within 2 h of onset. Method(s): A retrospective assessment of ED records was undertaken for stroke patients presenting to three hospitals in Melbourne over 6 months in 2010. Result(s): 798 patients were included in the study. Among acute stroke patients who presented within 2 h (n = 185), 173 (94%) were identified as stroke at triage with 10 cases identified as altered consciousness, unconscious. In all cases not identified as stroke the patient was diagnosed with intracerebral haemorrhage. 132 cases (71%) were allocated a triage category 1 or 2. Facial weakness (P = 0.002) and presentation to Monash Medical Centre (P <= 0.001), were significantly associated with triage category 1 or 2. Conclusion(s): Virtually all acute stroke patients were identified at triage, however 30% were not allocated an urgent triage category.