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Dive into the research topics where Marc Eckstein is active.

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Featured researches published by Marc Eckstein.


Stroke | 2009

Dispatcher Recognition of Stroke Using the National Academy Medical Priority Dispatch System

Brian Buck; Sidney Starkman; Marc Eckstein; Chelsea S. Kidwell; Jill Haines; Rainy Huang; Daniel Colby; Jeffrey L. Saver

Background and Purpose— Emergency medical dispatchers play an important role in optimizing stroke care if they are able to accurately identify calls regarding acute cerebrovascular disease. This study was undertaken to assess the diagnostic accuracy of the current national protocol guiding dispatcher questioning of 911 callers to identify stroke (QA Guide version 11.1 of the National Academy Medical Priority Dispatch System). Methods— We identified all Los Angeles Fire Department paramedic transports of patients to University of California Los Angeles Medical Center during the 12-month period from January to December 2005 in a prospectively maintained database. Dispatcher-assigned Medical Priority Dispatch System codes for each of these patient transports were abstracted from the paramedic run sheets and compared to final hospital discharge diagnosis. Results— Among 3474 transported patients, 96 (2.8%) had a final diagnosis of stroke or transient ischemic attack. Dispatchers assigned a code of potential stroke to 44.8% of patients with a final discharge diagnosis of stroke or TIA. Dispatcher identification of stroke showed a sensitivity of 0.41, specificity of 0.96, positive predictive value of 0.45, and negative predictive value of 0.95. Conclusions— Dispatcher recognition of stroke calls using the widely employed Medical Priority Dispatch System algorithm is suboptimal, with failure to identify more than half of stroke patients as likely stroke. Revisions to the current national dispatcher structured interview and symptom identification algorithm for stroke may facilitate more accurate recognition of stroke by emergency medical dispatchers.


Prehospital Emergency Care | 2014

Paramedics accurately apply the pediatric assessment triangle to drive management

Marianne Gausche-Hill; Marc Eckstein; Timothy Horeczko; Nancy E. McGrath; Aileen Kurobe; Linda Ullum; Amy H. Kaji; Roger J. Lewis

Abstract Objective. To provide an evaluation of the Pediatric Assessment Triangle (PAT) as an assessment tool for use by paramedic providers in the prehospital care of pediatric patients. Methods. Paramedics from Los Angeles Fire Department (LAFD) received training in the Pediatric Education for Prehospital Professionals (PEPP) course, PAT study procedures, and completed training in applying the PAT to assess children 0–14 years of age. A convenience sample of LAFD paramedic assessments of the pediatric patients transported to 29 participating institutions, over an 18-month period ending July 2010, were eligible for inclusion. Patients who were not transported were excluded from the study, as were the assessments of children with special health-care needs (CSHCN). PAT Study Forms, emergency medical services (EMS) report forms, and emergency department (ED) and hospital charts were entered into a secure database. Two study investigators, blinded to paramedic PAT assessment, reviewed hospital charts and determined the category of illness or injury. Results. A total of 1,552 PAT Study Forms were collected. Overall, 1,168 of the patient (75%) assessments met inclusion criteria, were transported, and had all three data points (PAT Study Form, paramedic EMS report form, and ED/hospital chart) available for analysis. When paramedics used the PAT to identify abnormalities in the three arms of the triangle (PAT Paramedic Pattern) and applied that pattern to form a general impression (PAT Paramedic Impression), the agreement resulted in a κ coefficient of 0.93 [95% CI: 0.91–0.95]. The PAT paramedic impression was congruent with field management, as the majority of patients received consistent interventions with local EMS protocols. The PAT Paramedic Impression for instability demonstrated a sensitivity of 77.4% [95% CI: 72.6–81.5%], a specificity of 90.0% [95% CI: 87.1–91.5%] with a positive likelihood ratio (LR+) of 7.7 [95% CI: 5.9–9.1] and a negative likelihood ratio (LR-) of 0.3 [95% CI: 0.2–0.3]. Conclusion. The PAT is a rapid assessment tool that can be readily and reliably used by paramedics in the prehospital setting. The PAT should be used in conjunction with other assessments but can safely drive initial field management.


Prehospital Emergency Care | 1999

Paramedic use of succinylcholine

Marc Eckstein


Stroke | 2018

Abstract WP337: Frequency, Determinants, and Outcomes of Intracerebral Hemorrhage Expansion in Hyperacute EMS-Transported Patients

Pitchamol Vilaisaktipakorn; Kristina Shkirkova; Christa D Brown; Gilda Avila-Rinek; Nerses Sanossian; David S. Liebeskind; Pablo Villablanca; Sidney Starkman; Marc Eckstein; Samuel J. Stratton; Frank Pratt; Robin Conwit; Scott Hamilton; Jeffrey L. Saver; Coordinators


Stroke | 2018

Abstract 6: Frequency, Risk Factors, Causes, and Outcomes of Early Neurological Deterioration in Hyperacute Cerebral Ischemia

Christa D Brown; Gilda Avila-Rinek; Nerses Sanossian; Sidney Starkman; Scott Hamilton; David S. Liebeskind; Dashiell F Young-Saver; Marc Eckstein; Samuel J. Stratton; Frank Pratt; Robin Conwit; Jeffrey L. Saver; Investigators


Stroke | 2018

Abstract WP223: Accelerating Growth in Medicare Beneficiary US Population Served by Mobile Stroke Units During Early Pilot Years (2014-2017)

May Nour; James C. Grotta; Stephanie Parker; Marianne Gausche-Hill; Nichole Bosson; Walid H Ghurabi; Marc Eckstein; Stephen Sanko; Sidney Starkman; Jeffrey L. Saver


Stroke | 2018

Abstract WP341: Imaging Predictors of Intracerebral Hematoma Expansion in Hyperacutely-Presenting Patients

Pitchamol Vilaisaktipakorn; Kristina Shkirkova; Nerses Sanossian; David S. Liebeskind; Pablo Villablanca; Sidney Starkman; Marc Eckstein; Samuel J. Stratton; Frank Pratt; Robin Conwit; Scott Hamilton; Jeffrey L. Saver; Coordinators


Stroke | 2015

Abstract W P215: Validation of Achievement of Target Blood Drug Levels by Paramedic Infusion Start in a Large, Pivotal Prehospital Stroke Trial

Kristina Shkirkova; Sidney Starkman; Nerses Sanossian; Marc Eckstein; Samuel J. Stratton; Frank Pratt; Robin Conwit; Scott Hamilton; Jeffrey L. Saver


Stroke | 2014

Abstract W MP59: Spanish Language Consent Process Increases Prehospital Clinical Trial Enrollment in the Hispanic Community

Samantha B Cherin; Nerses Sanossian; Latisha K Ali; Lucas Restrepo; Miguel Valdes Sueiras; Scott Hamilton; Robin Conwit; Marc Eckstein; Franklin D Pratt; Samuel J. Stratton; Sidney Starkman; Jeffrey L. Saver


Stroke | 2014

Abstract T MP52: Treatment Times are Reduced by Prehospital Initiation of Neuroprotective Stroke Therapy

Randy Sanoff; Samantha B Cherin; Nerses Sanossian; Robin Conwit; Scott Hamilton; Marc Eckstein; Samuel J. Stratton; Franklin D Pratt; David S. Liebeskind; Latisha K Ali; May Kim Tenser; Lucas Restrepo; Miguel Valdes Sueiras; Sidney Starkman; Jeffrey L. Saver

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Nerses Sanossian

University of Southern California

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Robin Conwit

National Institutes of Health

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Frank Pratt

New York City Fire Department

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