Stretcher Angles: Impact on Vital Signs and Optic Nerve Sheath Diameter in Prehospital Stroke Patients

Objective: Post-stroke hypoperfusion of brain tissue often results from increased intracranial pressure, compromising cerebral blood flow. This study investigated the relationships between the stretcher angles, the optic nerve sheath diameter (ONSD), and vital signs of stroke patients brought to the emergency department by emergency medical services (EMS).
Material and Methods: This was a prospective, cross-sectional, single-center study. The study included individuals over 18 years of age with a stroke according to the Cincinnati Stroke Scale. Patient age, sex, time to hospital arrival with an EMS, the ONSD, vital signs, clinical findings, the stretcher angle, and Glasgow Coma Scale (GCS) scores were recorded. Stretcher angles were adjusted into one of four different group.
Results: The study included 82 patients, and the average age was 74 years. The mean systolic blood pressure was 163±35 mmHg, the mean diastolic blood pressure was 91±17 mmHg, the mean right ONSD was 0.36±0.07 cm, and the mean left ONSD was 0.37±0.07 cm. The mean GCS of the patients was 13. The GCS was lower in Group 1 than in Group 3 (p=0.002); the DBP was greater in Group 4 than in Group 3 (p=0.023); and the ONSD was more significant in Group 4 than in Group 2 (p=0.007).
Conclusion: We recommend that EMS personnel carry stroke patients at 46-60° at a stretcher angle during transport. Prehospital EMS personnel must pay more attention to the stretcher angle and be informed about it when transporting patients with suspected strokes.

Keywords: Stroke, stretcher angle, intracranial pressure, optic nerve sheath diameter, prehospital, emergency department