So much for assessment tools
3 September 2008The Cincinnati Prehospital Stroke Scale is one of the few decision tools that EMS providers use commonly, making it rather important–so important, in fact, that it is codified into Pennsylvania state stroke protocol. Previous studies have shown the CPSS to pick up between 65-95% of strokes.
In San Diego, the CPSS isn’t working quite that well. In this study, it picked up less than half of strokes (44%). Worse still, the CPSS–which is based on face-to-face interaction with a patient–actually performs worse than the Medical Priority Dispatch System used by San Diego dispatchers, which picked up 83% of strokes.
It’s possible that people with strokes missed by CPSS were picked up with other clinical questioning, so I have no reason to worry about the patients–after all, the medics still have a full history and physical to form a working diagnosis and call for a stroke team if needed. By the same token, I’m still trying to explain a finiding this unexpected.
Ours is better than theirs?
Seems to me that it’s a game of validating the system each city is already using.