Abstract TMP24: Successful Implementation Of A Pediatric Stroke Alert System At A Non-academic Hospital

Introduction: Extensive research exists on the acute treatment of adult strokes, but delayed radiologic diagnosis prevents children from receiving the same interventions. Some academic institutions have implemented pediatric stroke protocols to improve early diagnosis, but without 24/7 in-house pediatric stroke coverage, the protocols are challenging to translate to non-academic hospitals. The goal of this study is to assess the implementation of a pediatric stroke alert protocol at a non-academic institution on time to diagnosis and access to acute treatment. Methods: This was an observational study. Pre-stroke alert patients admitted Feb. 19, 2014-Feb. 18, 2019 were retrospectively identified by stroke/TIA ICD-10 codes. Post-stroke alert patients were prospectively identified using our hospital notification system beginning Feb. 19, 2019- July 31, 2022 for ED stroke alerts and Feb. 19, 2020-July 31, 2022 for inpatient stroke alerts. Patients transferred with an existing stroke/TIA were excluded from the study. Non-parametric tests were used for statistical analysis. Results: 19 ED and 25 inpatient pre-stroke alert patients were identified. Post-stroke alert implementation, stroke/TIA was identified in 20/157 ED stroke alerts (12.74%) and 14/33 inpatient stroke alerts (42.42%). No significant difference was seen in time from ED arrival to diagnosis. However, time last seen well to diagnosis of stroke/TIA was significantly decreased for both ED and inpatient alerts (Table 1), resulting in 3 patients receiving intravenous thrombolysis. Conclusions: Although no significant difference was observed in time from ED arrival to diagnosis, implementation of a pediatric stroke alert protocol helped decrease time last seen well to stroke diagnosis. We speculate that increased awareness of pediatric stroke within the community and among medical staff, together with a defined stroke alert process, helped decrease the time of symptom onset to diagnosis.