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Stroke identification by criteria based dispatch - a register based study.

E N Ellensen1,2, H Naess3,4,5, T Wisborg6,7

  • 1Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway.

Acta Anaesthesiologica Scandinavica
|November 7, 2017
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Summary
This summary is machine-generated.

The Norwegian dispatch guidelines for stroke identification show modest sensitivity (57.9%) but high specificity (99.1%). Less than half of stroke patients initially contacted the emergency medical communication centre via the 113 telephone line.

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Area of Science:

  • Emergency medicine
  • Pre-hospital care
  • Neurology

Background:

  • Effective resource allocation in pre-hospital emergency medicine relies on rapid and precise dispatch.
  • Emergency medical communication centres (EMCCs) use protocols to balance patient needs with system resources.
  • Validating stroke identification protocols is crucial for timely emergency medical services.

Purpose of the Study:

  • To evaluate the accuracy of the Norwegian dispatch guidelines in identifying potential stroke patients.
  • To assess the sensitivity and specificity of current protocols used by EMCCs for stroke cases.

Main Methods:

  • A register-based study compared suspected stroke patients with confirmed stroke diagnoses.
  • Data from one EMCC and three hospitals over 13 months were analyzed.
  • Specific subcodes for stroke suspicion were examined, and associated factors explored.

Main Results:

  • The sensitivity for identifying stroke patients was 57.9%, with a specificity of 99.1%.
  • Positive and negative predictive values were 45.7% and 99.4%, respectively.
  • The 113 telephone line was the initial contact point in only 48% of cases; paralysis and smaller hospital admission increased stroke probability.

Conclusions:

  • The dispatch guidelines demonstrate modest sensitivity but high specificity for stroke identification.
  • The primary emergency number (113) is underutilized as the initial contact point for stroke patients.
  • Further improvements in dispatch protocols may be needed to enhance stroke case recognition.