A novel stroke and trauma alert system called ‘STRAUMA’ allows stroke patients to be rapidly assessed for traumatic injuries without delaying brain imaging and life-saving treatment, according to a new study from the US.
The system was developed by researchers at UCHealth Memorial Hospital in 2018.
If a serious injury is not found, the patient can be sent to immediate computed tomography (CT) to confirm ischemic or hemorrhagic stroke.
Patients who have suffered from ischemic stroke are routinely treated with a tissue plasminogen activator (tPA) to dissolve the clot. However, if the patient is bleeding from a serious injury, the drug can be harmful.
“The novel STRAUMA activation allows for an expedited evaluation of both stroke and trauma to facilitate timely administration of life-saving interventions,” said lead study author Janet Lee, MD, a fourth-year surgical resident at UCHealth Memorial Hospital in Colorado Springs, Colorado.
“Before administering tPA for the treatment of stroke, we want to rule out any injuries such as severe head trauma, intracranial hemorrhage, or bleeding risk that could cause catastrophic bleeding.”
In the study, researchers sought to find out whether the STRAUMA activation had an impact on time-to-CT and time-to-tPA administration.
The activation adds an extra step to the treatment process.
The researchers looked at the medical records of 580 adult men and women who had either a stroke alert or STRAUMA activation within 15 minutes of arrival at the hospital’s stroke centre over an 18-month period.
A total of 111 had a STRAUMA activation while 469 had triggered a stroke alert.
The researchers found that the STRAUMA activation added six minutes to the overall process. However, no differences were seen in the time-to-TPA.
Dr Lee said: “It’s all about risk versus benefit. The risk of patients with trauma getting tPA and having catastrophic bleeding outweighs the risk of a slight delay in CT scanning.”
The authors are now planning a larger study to explore the clinical outcomes between the two patient groups. Meanwhile, Dr. Lee and her colleagues will continue refine the STRAUMA process.
