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Acute stroke clinical care standard indicators: 1a-Assessment by ambulance services

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 1a-Assessment by ambulance services
METeOR identifier:Help on this term627650
Registration status:Help on this termHealth, Candidate 14/03/2017
Description:Help on this term

Proportion of patients with suspected acute stroke who are assessed using a validated stroke screening tool by ambulance services.

Rationale:Help on this term

Early recognition of acute stroke symptoms is critical to ensuring optimal outcomes for acute stroke patients (NSF 2010).

Indicator set:Help on this termClinical care standard indicators: acute stroke Health, Candidate 14/03/2017
Outcome area:Help on this termEarly assessment Health, Candidate 14/03/2017

Collection and usage attributes

Computation description:Help on this term

The reference population for this indicator could be the ambulance service or local hospital network (LHN). The choice of reference population depends on the service that is generating the indicators for local review (i.e. ambulance or health service), and the structure of ambulance services (i.e. whether they map to LHNs).

Both the numerator and the denominator include patients transported to hospital via ambulance with suspected acute stroke.

For the numerator, some validated screening tools for stroke include the F.A.S.T. (Face, Arm, Speech and Time) test (NSF 2015) and the Melbourne Ambulance Stroke Score (MASS) (Bray et al. 2005).

The F.A.S.T. test is:

  • FACE: Check their face. Has their mouth drooped?
  • ARM: Can they lift both arms?
  • SPEECH: Is their speech slurred? Do they understand you?
  • TIME: Time is critical. If you see any of these signs call 000 straight away.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients transported to hospital via ambulance with suspected acute stroke, who were screened for stroke by ambulance service staff using a validated screening tool, in the reference ambulance service or LHN.

Denominator:Help on this term

Number of patients transported to hospital via ambulance with suspected stroke in the reference ambulance service or LHN.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

Bray J, Martin J, Cooper G, Barger B, Bernard S & Bladin C 2005. Paramedic identification of stroke: community validation of the Melbourne ambulance stroke screen. Cerebrovascular Diseases 20(1):28–33

NSF (National Stroke Foundation) 2010. Clinical guidelines for stroke management. Melbourne: NSF

NSF 2015. Signs of stroke F.A.S.T. Viewed October 2015, https://strokefoundation.com.au/about-stroke/stroke-symptoms

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