PP22 Improving the detection of stroke and stroke mimics in the pre-hospital setting with stroke video triage in the east of England, UK

<h3>Background</h3> Pre-hospital Stroke Video Triage (PVT) has been live in the East of England (EoE) since October 2022. The pathway connects pre-hospital clinicians with stroke specialists via video call. PVT aims to enhance assessment of patients presenting with neurological symptoms and ensure patients get to the right treatment destination first time. <h3>Methods</h3> The provisional triage diagnosis was compared to the final diagnosis for 209 patients that were video triaged between December 2023 – April 2024 across all 9 live sites within the East of England. A control group was established of all Emergency Medical Services (EMS) suspected and hospital confirmed stroke patients conveyed to Peterborough City Hospital in March 2024. The sensitivity and specificity of PVT provisional diagnosis was compared to FAST and BEFAST (Chen et al, 2022). Triaging destination was analysed between December 2023 - April 2024 to determine the percentage of patients referred for further assessment by the stroke team compared to those directed to the Emergency Department. <h3>Results</h3> The average sensitivity of PVT diagnosis is 90% compared to 80% sensitivity in the control group. PVT sensitivity is superior to FAST (77%) and BEFAST (68%) as calculated by a contemporary systematic review and meta-analysis (Chen et al, 2022). Specificity of PVT diagnosis is 60% on average. 35% of patients are directed to the Emergency Department with no further input required from the Stroke Team. <h3>Conclusions</h3> PVT facilitates more accurate pre-hospital detection of stroke and stroke mimics than standard practice and the most used pre-hospital stroke screening tools in the UK. The pathway leads to accurate triage to Emergency Departments or Stroke Teams thereby streamlining patient care and increasing efficiency. PVT represents significant development in the pre-hospital care of suspected stroke patients. Analysis is ongoing with a full evaluation expected in October 2024.