Video Analysis Supporting Stroke Assessment within the Prehospital Care

Sammanfattning: Sweden, as well as the rest of the world has an increasing life-expectancy creating higher demands on the healthcare providers and on the quality of healthcare. Stroke is the third leading cause of death in Sweden. Prehospital stroke assessment is completed as rapid assessments by paramedics through the use of different stroke scales. Current stroke scales exclusively include qualitative data which results in a low sensitivity of the scales, thereby creating an over-triage of patients. Interrater variability is high, meaning different professionals conclude different assessments for the same patient. The time until treatment after a stroke is essential for the outcome. The faster a diagnosis can be determined the faster the patient can receive care. The paramedics have a large impact on the time from first care contact until diagnosis; therefore a correct stroke assessment is of immense importance. The aim of the thesis is to create a conceptual clinical support system to reduce the over-triage and interrater variability. The conceptual system produced is referred to as the suggested system. The suggested system includes video analysis of stroke patients in order to establish a more equal, patient oriented and knowledge based care. The suggested system detects four important parameters of stroke assessment. The parameters are extremity motor skills, facial-, eye- and head-movements. The four parameters cover eleven out of fifteen factors currently used to perform a stroke assessment at a hospital. The stroke scales used at hospitals are more extensive and detect larger varieties of strokes than prehospital stroke scales. The use of more extensive and accurate stroke scales in the prehospital area has previously been too time-consuming to complete. The output of the suggested system visualises an augmented reality that enhances the assessed parameters resulting in a positive stroke assessment, which provides support to paramedics and on-call doctors. The suggested system includes hardware and software placement and requirements as well as complexities with implementing new technologies and solutions in the prehospital care. Further discussed is the understanding of the single user as well as the integration of a novel system. The collaboration between hospitals and the prehospital environment is crucial for determining consequences, possibilities and difficulties in enhancing the current pathways of stroke assessment.