971448PoC stroke IVD for Paramedic useClosedSmall Business Research InitiativeInnovate UKStroke affects 150,000 in the UK each year. It is the 3rd largest contributor towards premature death and the single biggest cause of acquired adult disability. The NHS currently spends £4.4bn on treating stroke patients with a further £5bn lost from the economy because one third of survivors need frequent assistance for personal care. Stroke is caused by blockage (ischaemic; 85%) or bleeding (haemorrhagic; 15%) within the brain’s blood supply. Ischemic stroke is a treatable neuro-emergency, patient outcome is directly related to the speed at which clot busting drugs (thrombolytics) are administered or the clot is directly extracted (intra-arterial thrombecotmy). Both of these are time-critical treatments & patients are more likely to avoid significant disability if treated as soon as possible. More than 80% of stroke patients arrive in hospital by emergency ambulance. Minimising the time to intervention (scene to needle time) requires paramedics to very rapidly identify a potential stroke and transport them directly to the nearest Hyper Acute Stroke Unit (HASU) where dedicated stroke experts and brain imaging facilities are available. Time is critical, every minute delay in thrombolysis results in ~2 days lost healthy life. Stroke is a complex condition requiring clinical experts to make the final diagnosis after brain imaging. 40% of patients where paramedics suspect stroke have a “stroke mimic” which can look identical during initial assessment by the Face Arm Speech Test (FAST). Directing these patients to HASU for administration of stroke treatments is wasteful on resources and potentially hazardous due to treatment side effects. Likewise, paramedics typically do not identify 25% of genuine stroke patients, leading to delays in treatment. Unlike heart attacks (where ECGs can be used to check patients) there is no affordable rapid means of diagnosis stroke and it would be significant benefits for stroke and stroke mimic patients, and healthcare resources if a simple, portable test was available to paramedics. The NHS is working with Sarissa Biomedical to develop a simple Point of Care (PoC) blood test to help identify stroke victim. It relies on measuring blood purine levels as these are an extremely effective indicator of acute ischemia including stroke and are released from the earliest moments of pathology. Putting this technology in the hands of paramedics will enable them to more accurately stratify stroke victims and ensure they entry the correct clinical pathway more rapidly thereby shortening the ‘scene to needle’ time and improving the chance of a good outcome. Avoiding mislabelling of stroke mimic patients will free up existing resources within the HASUs resulting in a more effective and efficient uses of expensive NHS resources. This project proposes to adapt technology already developed for A&E use so that it can be carried and applied by paramedics at the point of initial patient assessment. To achieve this we will need to work with the Hospitals, the Ambulance services to understanding their needs to make sure the equipment is suitable for their environment. We will and draw on the expertise Oxford AHSN, the Ambulance service and HASUs to determine how the equipment would be used and integrated operationally and the health economic case to prove the value for money business case. The project will then plan a clinical trial within NHS ambulance services.