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"Time is brain, so we must BEFAST: Improving stroke identification and " by Donna Jay, Richard Wheatley et al.

Objective: Shoalhaven District Memorial Hospital is a rural (MM3) secondary hospital which is over an hour travel time from the nearest tertiary centre. The objective of the present study was to pilot the implementation of the BEFAST (Balance, Eyes, Face, Arms, Speech and Time) stroke screening tool at the ED, and determine whether its usage improved timely stroke detection. Methods: During initial implementation and training (October–December 2019), triage nurses consulted with senior medical officers before activating stroke calls. Data were collected for the subsequent 24 months (January 2020–2022), and retrospective records for confirmed strokes during a 24-month period prior to BEFAST implementation (October 2017–2019) were also collected. The main outcome measures were triage category, CT scan result time, discharge destination, length of stay (LOS) and Modified Rankin Score (MRS). Results: After BEFAST implementation, patients (n = 268) were three times more likely to be t ....

Shoalhaven District Memorial Hospital , Modified Rankin Score , Cerebrovascular Accident , Emergency Service ,

Dual antiplatelet therapy is noninferior to alteplase for patients with minor nondisabling acute ischemic stroke – the ARAMIS trial

1. The ARAMIS trial revealed that the rate of favourable neurologic function at 90 days was 93.8% among patients assigned to dual antiplatelet therapy (DAPT) compared to those assigned to intravenous alteplase at 91.4%. 2. This study shows evidence that DAPT is noninferior (with a difference greater than the prespecified margin of -4.5%) to alteplase ....

Rating Level , Acute Mild Ischemic Stroke , Modified Rankin Score ,