Prehospital Phase of the Stroke Chain of Survival: A Prospective Observational Study

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2016 May 4

PMID 27139735

Citations 25

Authors

Tuukka Puolakka

Daniel Strbian

Heini Harve

Markku Kuisma

Perttu J Lindsberg

Affiliations

Soon will be listed here.

Abstract

Background: Few studies have discussed the emergency call and prehospital care as a continuous process to decrease the prehospital and in-hospital delays for acute stroke. To identify features associated with early hospital arrival (<90 minutes) and treatment (<120 minutes), we analyzed the operation of current dispatch protocol and emergency medical services and compared stroke recognition by dispatchers and ambulance crews.

Methods And Results: This was a 2-year prospective observational study. All stroke patients who were transported to the hospital by emergency medical services and received recanalization therapy were recruited for the study. For a sample of 308 patients, the stroke code was activated in 206 (67%) and high priority was used in 258 (84%) of the emergency calls. Emergency medical services transported 285 (93%) of the patients using the stroke code and 269 (87%) using high priority. In the univariate analysis, the most dominant predictors of early hospital arrival were transport using stroke code (P=0.001) and high priority (P=0.002) and onset-to-call (P<0.0001) and on-scene times (P=0.052). In the regression analysis, the influences of high-priority transport (P<0.01) and onset-to-call time (P<0.001) prevailed as significant in both dichotomies of early arrival and treatment. The on-scene time was found to be surprisingly long (>23.5 minutes) for both early and late-arriving patients.

Conclusions: Fast emergency medical services activation and ambulance transport promoted early hospital arrival and treatment. Although patient-dependent delays still dominate the prehospital process, it should be ensured that the minutes on the scene are well spent.

Citing Articles

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Racial Impact on Inpatient Stroke Quality of Care in Two Community Hospitals.

Hussein H, Yang M, Ramezani S, Sharma R, Ul Haq Lodhi O, Owens-Pochinka Y J Clin Med. 2023; 12(24).

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Berg K, Sorensen V, Blomberg S, Christensen H, Kruuse C BMC Emerg Med. 2023; 23(1):96.

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de Melo Silva Junior M, Oliveira A, Gois W, Oliveira M, de Gois L, Ferreira L BMC Neurol. 2023; 23(1):273.

PMID: 37464301 PMC: 10355005. DOI: 10.1186/s12883-023-03327-y.

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