Stroke Alert vs Trauma Alert

There are several times that we get cases where it's unclear whether we're dealing with a stroke alert or a patient with head trauma and bleed in the brain with stroke like symptoms. We've had a couple of cases recently here at Palm Beach County Fire Rescue and at some of the other agencies around our county, which prompted the healthcare district and their Trauma Quality Improvement Committee to give ACE a formal recommendation, a formal letter, and how they recommend that we deal with these cases. Basically, Both Delray and St. Mary's in addition to being trauma centers, are comprehensive stroke centers. The feeling of the trauma experts and their neurosurgical experts is that if we are in doubt whether we're dealing with a stroke alert versus a trauma alert, meaning we have a case where a patient has stroke like symptoms who also seems to have hit their head, either because we're worried that they had a stroke and then fell and hit their head, or whether we think it's simply a patient who fell and hit their head and now have bleeding in their brain, have stroke like symptoms they prefer. Whenever there's doubt as to whether there's a head trauma issue versus just a pure stroke issue, that we deal with it like it is a trauma alert issue. Their suggestion is because of this, they say that the trauma folks are in house 24 7, but their stroke folks are not necessarily in house 24 7, and that their internal hospital processes are faster. If we go down the trauma route. Both of these two cases, whether it be a trauma alert with bleeding in the brain with stroke like symptoms, or whether it simply be a stroke alert that might have some sort of minor bump on the head, both of them are going to require rapid imaging. They feel that the imaging systems that they have in the hospital goes faster if we call it a trauma alert, and if the patient turns out not to be a trauma alert, they can rapidly transfer that patient over to their stroke service and get the patient the care they need.

So this is in contrast to us calling it a stroke alert and then the stroke team coming in and finding out that actually it's a bleed in the brain. So for any future cases where you've got a patient who has a stroke with a possible head injury and you're not sure whether you're dealing with head injury or stroke, call it a trauma alert. So when you call it a trauma alert, they'll be able to sort it out at the hospital. It really is impossible for us to differentiate the two in the field. So let those folks do it. Their processes are faster when we go down that road. So that's what I'm suggesting we do, that we adopt their advice.