KMID : 0359720110290020089
|
|
Journal of the Korean Neurological Association 2011 Volume.29 No. 2 p.89 ~ p.94
|
|
Prehospital Delay Factors After Stroke and Paramedic Identification of Stroke Patients in a Metropolitan City Emergency Medical Service System
|
|
Kim Hae-Jong
Kim Dae-Hyun Park Hyang-I Lee In-Young Cha Jae-Kwan
|
|
Abstract
|
|
|
Background: Accurate recognition of stroke victims by ambulance paramedics is necessary to ensure the rapid transfer of these patients to the hospital. We carried out a prospective study to characterize the cause of prehospital delays after stroke by the emergency medical service (EMS) and to determine the accuracy of identifying acute stroke by paramedics.
Methods: All paramedics in the Busan Metropolitan 119 EMS were asked to record the clinical presentations and time intervals from symptom onset to various points along the patients¡¯ prehospital course on the ambulance admission sheets for suspected stroke patients during a month (February 1, 2010 to February 28, 2010). Neurologists in twenty four hospitals reviewed the hospital records for the patients who were given a diagnosis of stroke or transient ischemic attack by the paramedics.
Results: Of the EMS on-scene evaluations, the diagnosis of stroke by ambulance paramedics was correct for 79 of the 186 (43%) patients. Positive predictive values for main suspected stroke symptoms were 95% in hemiparesis, 88% in speech disturbance and 44% in impaired consciousness. The prehospital personnel transferred the suspected stroke patients to each hospital at a mean of 25 minutes after the emergency 119 call. However, only 62% of the stroke patients called EMS within the first 2 hours of stroke.
Conclusions: Public education for the need to seek EMS promptly after stroke as a medical emergency, and stroke- specific training for EMS personnel are essential so that stroke patients receive effective acute treatment.
|
|
KEYWORD
|
|
Stroke recognition, Emergency medical service, Prehospital delay, Paramedics
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|