Development of a Regional Drip and Ship Protocol at Referring Stroke Thrombolysis Centres to Support Timely Access to Stroke Endovascular Therapy
Bibliographic record
Abstract
Background: Stroke Endovascular Therapy (EVT) is a highly specialized neurointerventional procedure provided at regional or tertiary level stroke centres. It requires a regional approach, building on existing local thrombolysis protocols to ensure timely referral and transfer for EVT. Within Central South Ontario, half of the EVT patients treated at the regional EVT centre are from referring sites. As a result, it is imperative to develop a regional drip and ship protocol to support the safe and timely transfer to the EVT centre and minimize delays to transfer. Methods:Consultation with local EMS providers identified the necessary protocols required to support safe transport. An environmental scan of existing Drip and Ship Protocols was completed. Representatives from referring thrombolysis centres were brought together to develop a regional drip and ship order set to support the safe transport of EVT patient who receive IV thrombolysis (tPA )and those who have not received IV tPA to the endovascular centre. Results:Local drip and ship protocols were developed that addressed: 1) EVT pre-procedural orders; 2) vital sign and neurological monitoring: 3) monitoring and management of tPA complication; 4) management of contrast dye allergic reaction; and 5) other symptom management on route. In addition to the Drip and Ship Order sets, centres developed EVT Transport Order Sets, Patient EVT Transfer Policies, EVT Transport Checklists; EVT Transport Medication Kits and Transfer Documentation Records. Conclusions:Collaborative development of a regional drip and ship process has supported the safe transport of regional EVT cases and limited delays to treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.078 | 0.083 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".