Abstract TP052: CÓDIGO DERRAME (STROKE CODE)

Introduction: In Guatemala the prevalence is estimated at 18-20 cases per 100,000 inhabitants “DERRAME Code” initiative was created by our group for a better identification and management of acute Stroke patients, given the common colloquial name by which our regional population identifies the term stroke, making this name equivalent to STROKE CODE. For mainly pre-hospital management purposes. This initiative was initiated a decade ago including population and paramedical personnel training and continuing with medical training with internal medicine residents at public medical school hospital. In Guatemala the mnemonic DERRAME originates from: D ificultad para hablar (Difficulty speaking), E ntiende poco (Poor understanding), R ápido Inicio (Rapid onset), D esviación facial (Deviated face), A lteración visual (Altered vision), M edico cuerpo débil (One side motor symptoms), E mergencia (Emergency). This initiative was temporaly suspended during the COVID- 19 pandemic and formally reinitiated January this year. Objective: To improve the early pre-hospital identification and early arrival to a qualified hospital within the 4.5-hour time window, for thrombolytic treatment Methodology: Analytical, prospective, cross-sectional study from January to July 2025. The trainees were given a pretest- and a post-training test. The test included 10 questions for paramedics regarding prehospital approach and management and 20 questions for medicine resident physicians regarding hospital management in acute stroke patients. Then, analyzed data obtained from thrombolyzed patients. Results: 1. 153 paramedics and 50 resident physicians were trained during first semester 2025. 2. The knowledge of acute stroke management by paramedics and internal medicine residents improved by more than 90%. 3. The number of thrombolyzed patients in our hospital increased during this period by 60% compared to four prior semesters (2023 and 2024). There was only one intraparenchymal hemorrhage associated to the thrombolytic procedure in this period with no other complications documented. Conclusions: 1. Training of paramedic personnel and emergency medical personnel showed a significant improvement in early and effective acute care in stroke patients with an increased number of thrombolyzed patients with minimal side effects 2. This initiative is currently in the process of involving a significant increase of public hospitals, aiming to improve the acute stroke care in Guatemala.