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Title: Stroke symptoms and the decision to call for an ambulance.
Austin Authors: Mosley, Ian;Nicol, Marcus;Donnan, Geoffrey A ;Patrick, Ian;Dewey, Helen M
Affiliation: National Stroke Research Institute Level 1 Neurosciences Building, Austin Health, 300 Waterdale Road, Heidelberg Heights Victoria 3181, Australia
Issue Date: 4-Jan-2007
Publication information: Stroke; A Journal of Cerebral Circulation 2007; 38(2): 361-6
Abstract: Few acute stroke patients are treated with alteplase, partly because of significant prehospital delays after symptom onset. The aim of this study was to determine among ambulance-transported stroke patients factors associated with stroke recognition and factors associated with a call for ambulance assistance within 1 hour from symptom onset.For 6 months in 2004, all ambulance-transported stroke or transient ischemic attack patients arriving from a geographically defined region in Melbourne (Australia) to 1 of 3 hospital emergency departments were assessed. Tapes of the call for ambulance assistance were analyzed and the patient and the caller were interviewed.One hundred ninety-eight patients were included in the study. Stroke was reported as the problem in 44% of ambulance calls. Unprompted stroke recognition was independently associated with facial droop (P=0.015) and a history of stroke or transient ischemic attack (P<0.001). More than half of the calls for ambulance assistance were made within 1 hour from symptom onset and only 43% of these callers spontaneously identified the problem as "stroke." Factors independently associated with a call within 1 hour were: speech problems (P=0.009), caller family history of stroke (P=0.017), and the patient was not alone at symptom onset (P=0.018).Stroke was reported as the problem (unprompted) by <50% of callers. Fewer than half the calls were made within 1 hour from symptom onset. Interventions are needed to more strongly link stroke recognition to immediate action and increase the number of stroke patients eligible for acute treatment.
Gov't Doc #: 17204685
DOI: 10.1161/
Journal: Stroke
Type: Journal Article
Subjects: Aged
Decision Making
Emergency Medical Service Communication Systems
Emergency Medical Services
Time Factors
Transportation of Patients
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