MEND EMS 2.1

The Miami Emergency Neurologic Deficit (MEND) Examination serves as a focused neurologic assessment tool designed to assist healthcare professionals in promptly identifying stroke patients. This assessment encompasses components from both the Cincinnati Prehospital Stroke Scale (CPSS) and the NIH Stroke Scale (NIHSS).

The MEND EMS application streamlines the detection and management of stroke cases in prehospital settings. It is structured into tabs, guiding users through key sections including History, CPSS, MEND examination, management considerations, references, and the ED report. Users are initially prompted to select between initiating information for a new patient or continuing data entry for an existing one.

Developed collaboratively by a team of stroke experts including neurologists, emergency physicians, neurology nurses, and paramedics, the MEND exam allows for detailed observations that enable paramedics to conduct a thorough assessment of stroke severity and syndrome identification. Moreover, it facilitates efficient communication with receiving hospitals and allows for continuity in patient care from initial assessment to hospital admission.

It is recommended that EMS personnel first perform the CPSS on scene and commence transport; subsequently, they should conduct the comprehensive MEND exam during transport to minimize delays. The MEND exam is integrated into an overarching stroke curriculum known as Advanced Stroke Life Support.

The application comprises the following pivotal components:

• History: Includes age, sex, chief complaint, time last seen normal, and pertinent preliminary questions such as witness information.
• On Scene Cincinnati Prehospital Stroke Scale (CPSS): Structured in a checklist format.
• MEND Examination: Presented in a checklist format.
• Management / Vital Signs / References:
  • - Consider Initiating Stroke Alert
  • - Prevent aspiration
  • - Monitor blood glucose
  • - References: Covering Stroke Mimics & t-PA exclusion criteria
• ED Report: This section consolidates all collected data into a concise bullet point list for clear communication with the emergency department of the receiving hospital.