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Specialized Care Centers and Settings-II

Specialized Care Centers and Settings-II

Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...

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Updated: May 15, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study.

Emma N Johnson¹, Mahesh V Pinapaka¹, Mary E Grewe²

¹Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Prehospital Emergency Care

|April 10, 2025

Summary

Rural emergency medical services (EMS) identify public education and community engagement as key to improving acute stroke care. Enhancing communication and prehospital protocols are also vital for better stroke outcomes in underserved areas.

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Area of Science:

Emergency medicine
Neurology
Public health

Background:

Emergency medical services (EMS) are critical for acute stroke care in rural communities with limited access to specialized centers.
Understanding the perspectives of rural EMS professionals is essential for optimizing stroke care delivery.

Purpose of the Study:

To explore rural EMS professionals' views on the barriers and facilitators to providing optimal acute stroke care.
To identify areas for improvement in prehospital stroke management within rural settings.

Main Methods:

Qualitative study involving semi-structured interviews with 12 EMS professionals from rural and mixed urban-rural agencies in North Carolina.
Interviews covered stroke training, experience, patient characteristics, workflows, and system interactions.
Thematic analysis of transcribed interviews using inductive and deductive coding in MAXQDA software.

Main Results:

Facilitators included stroke assessment protocols, destination decision protocols, and bidirectional communication between EMS and hospitals.
Barriers identified were patient/bystander delays in calling emergency services, long transport distances, limited EMS staffing, and challenges during patient transfer.
Public education on stroke signs/symptoms and community engagement were highlighted as important.

Conclusions:

Public education and community engagement are high-priority needs for improving stroke care in rural populations.
EMS can enhance rural stroke care through consistent bidirectional communication and improved prehospital protocols.
Further research is recommended in rural EMS agencies outside of North Carolina.