Reducing Door-In to Door-Out Time for Patients Receiving a Mechanical Thrombectomy Using AutoLaunch Protocol

Abstract

Devin M Howell,1,2 Timmy Li,1 Elizabeth Quellhorst,2 Jeffrey M Katz,3 Rohan Arora,3 Jonathan Berkowitz2 1Department of Emergency Medicine, Northwell Health, Manhasset, NY, USA; 2Center for Emergency Medical Services, Northwell Health, Syosset, NY, USA; 3Department of Neurology, Northwell Health, Manhasset, NY, USACorrespondence: Devin M Howell, Department of Emergency Medicine, Northwell Health, 300 Community Drive, Manhasset, NY, 11030, USA, Email [email protected]: Door-in to door-out (DIDO) time for large vessel occlusion (LVO) stroke is an emerging stroke performance measure. Initial presentation at a non-Comprehensive Stroke Center (CSC) requires a transfer process that minimizes delays. Our objective was to assess whether DIDO time for stroke patients was reduced after implementation of an AutoLaunch protocol for interfacility transfers.Methods: This was a pre-post analysis of an AutoLaunch protocol for all acute stroke patients transferred to a CSC for mechanical thrombectomy. The distribution of DIDO times between patients transferred via the AutoLaunch and traditional dispatch protocols were compared.Results: We evaluated 92 interfacility transfers, with 22 utilizing the AutoLaunch protocol and 70 utilizing traditional dispatch. Among AutoLaunch transfers, the median DIDO time was 85 minutes (IQR: 71, 133), while the median DIDO time among the traditional transfers was 109 minutes (IQR, 84, 144) (p=0.044).Conclusion: Implementation of an AutoLaunch protocol for patients with suspected LVO was associated with a reduction in DIDO time to CSCs. Further studies should evaluate patient outcomes based on transfer strategies.Keywords: AutoLaunch, interfacility, transfer, EMS, stroke

Keywords

• autolaunch
• interfacility
• transfer
• ems
• stroke