Updated Protocol for Stroke Code Management in Prehospital Settings: The Iranian Comprehensive Stroke Code Management Program (ICSCM Phase II).

Introduction: Code stroke is a framework to reduce time and improve the quality of care in the prehospital setting. However, increased scene time, delays, and other barriers in the prehospital setting necessitate updating the current protocol. This study aimed to update the Iranian national code str...

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Publicado en:Archives of Academic Emergency Medicine Vol. 13; no. 1; pp. 1 - 17
Autores principales: Alijanpour, Shayan, Bahramnezhad, Fatemeh, Mowla, Ashkan, Shafiee Sabet, Mahdi, Dehghan Nayeri, Nahid
Formato: glossary practice guidelines protocol research tables/charts Journal Article
Publicado: Shahid Beheshti University of Medical Sciences 2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Updated Protocol for Stroke Code Management in Prehospital Settings: The Iranian Comprehensive Stroke Code Management Program (ICSCM Phase II).
      aug:
        au:
          Alijanpour, Shayan
          Bahramnezhad, Fatemeh
          Mowla, Ashkan
          Shafiee Sabet, Mahdi
          Dehghan Nayeri, Nahid
        affil: Students Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
      sug:
        subj:
          Stroke Therapy
          Prehospital Care
          Protocols
          Human
          Male
          Female
          Adult
          Middle Age
          Iran
          Multimethod Studies
          Qualitative Studies
          Quantitative Studies
          Purposive Sample
          Blood Glucose
          Electrocardiography
          Treatment Delay
          Quality of Health Care
          Treatment Outcomes
          Brainstorming
          Job Experience
          Delphi Technique
          Quality Improvement
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Introduction: Code stroke is a framework to reduce time and improve the quality of care in the prehospital setting. However, increased scene time, delays, and other barriers in the prehospital setting necessitate updating the current protocol. This study aimed to update the Iranian national code stroke protocol for the prehospital setting. Methods: This study represents the results of the second phase of the Iranian Comprehensive Stroke Code Management Program, a mixed methods study. We used the Caspian scientific 10-step method to update this protocol, which included a literature review, critical appraisal, extraction of recommendations, face-content validity, the Delphi method, RAND method, expert panel, stakeholders, and publishing and printing. We divided the updated protocol into three stages (on scene, ambulance care, and on admission). Results: Twenty experts (55% nurses; mean age 40.7±9.1 years, experience 15.9±7.9 years) were enrolled. On-Scene focuses on rapid ABC (airway, breathing, circulation) assessment, BEFAST (balance, eyes, face, arm, speech, and time) criteria, blood glucose check, and on-scene time under 5 minutes. Ambulance Care Involving SAMPLER (Symptoms, Allergies, Medications, Past medical history, Last time the patient was seen normally, Events leading up to the emergency medical service call, and Risk factor) history-taking, maintaining oxygen saturation ≥94%, symptom/witness documentation, electrocardiography (ECG) for cardiac-stroke cases, master’s degree (MSN)-led transport coordination, and neurology team alerts and in-hospital admission ensuring precise handover, 724 pager alerts, stroke code clocks, computed tomography (CT)-ready team, and protocol updates via joint committees. Conclusion: The main points were the stroke clock, pager 724, direct delivery to computed tomography scan, administering BEFAST, and reducing scene time. We recommend that each center to enhance the infrastructure and resources for implementation of these updates. In the next phase, we will implement and evaluate this protocol.
      pubtype: Academic Journal
      doctype:
        glossary
        practice guidelines
        protocol
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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