A digital clock that sounds alarms signalling each step of acute stroke care at the hospital is a low cost tool that helped doctors in Germany streamline and accelerate the time-sensitive process, according to new research published recently in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
The success of emergency stroke treatment depends on how fast treatment is delivered. The American Heart Association/American Stroke Association’s target: Stroke quality improvement initiative recommends 60 minutes or less from the time a stroke patient arrives to the hospital to the time of clot-busting treatment.
Study author Klaus Fassbender, who is also professor of neurology at Saarland University Medical Center (Homburg, Germany), says: “Time is brain. Minutes are easily lost in acute stroke management, despite standard protocols. The stroke alarm clock is a low-cost intervention and an efficient way to quickly deliver life-saving treatment to acute stroke patients.”
In the study, a large-display alarm clock was installed in the hospital’s computed tomography (CT) room, which is where stroke patients are admitted, neurological examinations are performed, and clot-busting medication is administered. The clock is set at the time of admission, and alarms sound when various treatment procedures should have been completed. For example, at 15 minutes for the neurological exam, 25 minutes for imaging and laboratory tests, and 30 minutes for the start of intravenous thrombolysis treatment.
The study was conducted from February 2016 to November 2017. The two patient groups who were selected for either the alarm clock or regular care were similar regarding demographics and medical characteristics, including final diagnoses, stroke impairment, and degree of disability or dependence at hospital arrival. Of the 107 acute stroke patients selected, 51 were treated utilising the clock to time care, compared to 56 patients who were treated without using the clock as the timer.
The research found that the time from arrival to neurological examination completion was 7.28 minutes in the stroke clock group, versus 10 minutes in the comparison group. The arrival to start of intravenous thrombolysis treatment times were median 18.83 minutes in the stroke clock group, versus 47 minutes in the comparison group. The use of the clock did not remarkably improve arrival to mechanical clot-busting times.
Stroke patients’ functional abilities were not notably different 90 days after treatment, regardless of whether they received care with or without the clock.
“However, this study was not designed to measure results of treatment in the months or years following acute stroke care,” notes Fassbender, adding that “a limitation of this study was its size. We need more patients to determine whether accelerated acute stroke management with the clock translates to less death and disability long-term.”