DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20213008

Stroke recognition efficiency by emergency medical dispatchers

Nantawan Tippayanate, Supalak Chaleepad, Nirun Intarut

Abstract


Background: Delaying treatment for an acute stroke can typically lead to further severity and disastrous consequences. The majority of patients, however, did not arrive at the hospital in time to get thrombolysis. While the accuracy of stroke diagnosis by emergency medical dispatchers (EMDs) remains uncertain. The focus of this research was to assess the accuracy of the stroke detection (face-arm-speech-time tool) (FAST) utilized by EMDs for the management of acute stroke was as well as how it affected patients' time from door to CT and door-to-needle time.

Methods: From 1 January 2020 to 31 December 2020, this research was performed retrospectively. We included all patients over the age of 18 who had an acute stroke identified by incident dispatch code 18. Data was gathered using pre-hospital forms and hospital records. The CT scan findings were used to predict the overall diagnosis.

Results: Overall 244 patients, only 143 likely cases (62.4%) were identified by EMDs out of 181 final stroke diagnosis. Conversely, the specificity was 44.4 percent and the sensitivity was 63.5 percent. Only 19 patients (10.5%) obtained a CT scan within 60 minutes, per the data from acute stroke patients, whereas only 40 patients with acute ischemic stroke acquired r-TPA (22.1%).

Conclusions: It remains undecided if the failure to use FAST, the inability to recognize positive FAST indicators, or the failure to report FAST findings involves issues with EMDs assessments.

 


Keywords


Stroke recognition accuracy, EMD, Door-to-needle time, Door to CT, Command control center

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