Statewide survey of 911 communication centers on acute stroke and myocardial infarction

We conducted a statewide survey of communication centers regarding practices, training, and outreach for stroke and myocardial infarction (MI) and explored differences for those that were Emergency Medical Dispatch (EMD) certified or not.

A survey was mailed to all 115 centers that dispatched for emergency medical services (EMS) in North Carolina. Seventy-four percent (85/115) returned the survey.

For 31% of centers, all telecommunicators were EMD-certified, 28% of centers had some personnel certified, and 41% had no personnel certified. Forty-four percent of centers used dispatch guides or algorithms to aid telecommunicators. If telecommunicators suspected a stroke, 47% of the centers provided prearrival instructions and if they suspected an MI, 49% provided prearrival instructions. In the past 2 years, 27% of the telecommunicators received stroke-specific training and 29% received MI-specific training. Stroke or MI training for telecommunicators was more common among the EMD centers (51% stroke; 51% MI) than among the non-EMD centers (5% stroke; 9% MI). Only one center conducted a community outreach program about stroke or MI in the last 6 months.

Our results suggest that the development of statewide telecommunication training program to improve knowledge and care for suspected stroke or MI is needed in North Carolina. Dispatching for stroke and MI could be enhanced by requiring all communication centers to be EMD-certified and by creating consistent and standard dispatching practices across the state, using triage algorithms. Implementing these changes could improve rapid response and care for acute stroke and MI patients.