Assessment of Stroke Patients’ Status and Their Transfer Time by Emergency Medical Services to Valiasr Hospital in Arak City, Iran

Abstract

Background: Stroke is a major cause of death and disability in the world and these complications can be decreased by competent emergency care. Emergency medical service (EMS) transfer half of the stroke patients to hospitals. This study aimed to determine diagnosis of status and transfer time of stroke patients by EMS to a main hospital (Valiasr) in Arak City. Materials and Methods:This study was a descriptive analytic study and conducted on 43 patients with a diagnosis of stroke that transferred by EMS to Valiasr Hospital in Arak City. Data were collected through a checklist which contained information about age, sex, type of accident, response time, scene time, transfer time, and total time from inpatients records and Emergency Center statistics. Regarding data analysis, descriptive statistical tests were performed by SPSS 19. Results:The mean(SD) age of patients was 73.7(3.8) years and 51.2% of them were women. The stroke diagnosis by EMS technicians was correct in 15(34.9%) cases. In 20(46.5%) cases, the diagnosis was wrong and in 8(18.6%) cases, there were not any diagnosis. The most common non-stroke condition was confusion. The mean response time and arrival time to location, transfer time, and total time were 6.9, 16.9, 9.1, and 35.3 minutes, respectively. In patients with correct diagnosis and wrong or no diagnosis, these mean times were 7, 17.1, 3.9, and 35.7 minutes and 6.9, 16.8, 9.7, and 33.5 minutes, respectively. Conclusion:The results of this study showed that an accurate diagnosis by EMS technicians could be an indicator for faster transfer of the patient to treatment center. It is recommended that more appropriate pre-hospital diagnosis tools of stroke be developed and handed to EMS staff, for more accurate diagnosis of strokes and their better treatment.

The Accuracy of Diagnosis and Treatment Made by Pre-hospital Emergency Medical Technicians in Patients Admitted to Hospitals in Qazvin, Iran

“…In the study by Bahrampour et al, diagnosis of stroke made by EMTs was correct in 15 patients (34.9%), wrong in 20 patients (46.5%), and in 8 (18.6%) no diagnosed was made [27]. In the study by Shakeri et al, EMTs were in a good level in most skills, but they need to receive the necessary training in two skills in which they had no sufficient score [28].…”

“…Triage is essential for the initial clinical evaluation and classification of all patients referred to the emergency department to provide the most appropriate treatment [23]. An incorrect triage will result in wasted resources, overuse of ambulance transport to hospitals, lim-ited availability of ambulances, overcrowding of emergency centers, delays in patient treatment, dissatisfaction, and adverse outcomes, while a correct triage can be useful in determining the line of treatment for patients, and facilitating the process of stabilizing their conditions and their admission [27]. Therefore, a correct on-site diagnosis can lead to better use of resources.…”