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Dispatcher Stroke Recognition Using a Stroke Screening Tool: A Systematic Review.

John Adam Oostema1, Trevor Carle, Nadine Talia

  • 1Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, Mich., USA.

Cerebrovascular Diseases (Basel, Switzerland)
|June 28, 2016
PubMed
Summary
This summary is machine-generated.

Emergency dispatchers using stroke screening tools had suboptimal accuracy in recognizing strokes. Further research is needed to improve dispatcher stroke recognition for faster emergency medical services response.

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Area of Science:

  • Emergency medicine
  • Neurology
  • Public health

Background:

  • Emergency dispatchers are the first point of contact for acute stroke response.
  • Accurate dispatcher stroke recognition is crucial for timely emergency medical services (EMS) response.
  • Stroke is frequently unrecognized during initial emergency calls, delaying critical care.

Purpose of the Study:

  • To systematically review the accuracy of emergency dispatcher stroke recognition when using stroke screening tools.
  • To evaluate the effectiveness of tools like the Cincinnati Prehospital Stroke Scale in improving dispatcher accuracy.
  • To identify gaps in research regarding dispatcher stroke recognition, especially for acute stroke therapies.

Main Methods:

  • Comprehensive database search (Medline, EMBASE, CINAHL, Cochrane) for studies on dispatcher stroke recognition.
  • Inclusion of studies reporting dispatcher use of validated stroke screening tools (e.g., MPDS, FAST).
  • Data abstraction and quality assessment (QUADAS-2) by two independent reviewers, using hospital-based stroke diagnosis as the reference standard.

Main Results:

  • Seven studies (3 retrospective, 4 prospective) with 16,382 patients met inclusion criteria.
  • Sensitivity for dispatcher stroke recognition ranged from 41-83%, and positive predictive value (PPV) ranged from 42-68%.
  • Limitations included variable reference standards and unclear subject exclusion criteria; no studies compared algorithms or focused on candidates for acute therapies.

Conclusions:

  • Emergency dispatcher stroke recognition accuracy remains suboptimal, even with screening tools.
  • Further research is essential to understand the causes of poor recognition.
  • Future studies should prioritize improving dispatcher accuracy for patients eligible for time-dependent stroke treatments.