The effect and associated factors of dispatcher recognition of stroke: A retrospective observational study

Hsieh, Ming‐Ju; Chien, Kuo‐Liong; Sun, Jen‐Tang; Tang, Sung‐Chun; Tsai, Li-Kai; Chiang, Wen-Chu; Chien, Yu-Chun; Jeng, Jiann‐Shing; Huei‐Ming, Matthew

doi:10.1016/j.jfma.2017.10.008

Cited by 11 publications

(20 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study from Taiwan directed at increasing community awareness of stroke symptoms, approximately half the callers to the dispatchers suspected that the symptoms being experienced were related to a stroke. The medical dispatchers were more likely to activate stroke protocols and there was a higher likelihood of thrombolysis during the admission [29]. Another recent study identified that focussing on recognizing FAST symptoms, speech disturbances and a fall at onset improved the identification of stroke by dispatchers [30].…”

Section: Pre-hospital Dispatch Evaluation Of Stroke Mimicsmentioning

confidence: 99%

See 1 more Smart Citation

Stroke mimics: incidence, aetiology, clinical features and treatment

et al. 2021

View full text Add to dashboard Cite

Mimics account for almost half of hospital admissions for suspected stroke. Stroke mimics may present as a functional (conversion) disorder or may be part of the symptomatology of a neurological or medical disorder. While many underlying conditions can be recognized rapidly by careful assessment, a significant proportion of patients unfortunately still receive thrombolysis and admission to a high-intensity stroke unit with inherent risks and unnecessary costs. Accurate diagnosis is important as recurrent presentations may be common in many disorders. A non-contrast CT is not sufficient to make a diagnosis of acute stroke as the test may be normal very early following an acute stroke. Multi-modal CT or magnetic resonance imaging (MRI) may be helpful to confirm an acute ischaemic stroke and are necessary if stroke mimics are suspected. Treatment in neurological and medical mimics results in prompt resolution of the symptoms. Treatment of functional disorders can be challenging and is often incomplete and requires early psychiatric intervention.

show abstract

Section: Pre-hospital Dispatch Evaluation Of Stroke Mimicsmentioning

confidence: 99%

“…In addition, improvement in public awareness of the symptoms of stroke will also be very helpful. Dispatchers are more likely to think that the patient is having a stroke if the callers believe that the symptoms may be related to a stroke [29].…”

Section: Strategies To Improve Diagnosismentioning

confidence: 99%

Stroke mimics: incidence, aetiology, clinical features and treatment

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The analysis suggests that a significant number of stroke calls are not detected as strokes (33.83%) within the 1-1-2 and 1813 emergency medical contact points. Considering the positive effects stroke recognition at the EMS takes on the stroke related outcome, the improvement of stroke detection at the EMS is crucial [ 14 – 16 , 18 , 19 ]. This research suggests the usage of an ASR, based on the model of CORTI AI for OHCA, to increase stroke recognition at the EMS from 52.75 to 61.19%.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has shown, that the accurate and early stroke detection by the EMS plays an important role in the timely hospital admission of stroke patients, through dispatching a high priority ambulance (“A” response) [ 14 – 17 ]. Hsieh et al [ 18 ] and Oostema et al [ 19 ] have found that stroke detection by Emergency Medical Dispatchers (EMDs) leads to an improved stroke care and accordingly a better outcome for stroke patients [ 20 ]. However, several studies have shown that the accuracy of stroke detection among EMDs are highly variable, between 30 and 83% [ 8 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence in Emergency Medical Services dispatching: assessing the potential impact of an automatic speech recognition software on stroke detection taking the Capital Region of Denmark as case in point

Scholz

Collatz-Christensen

Blomberg

et al. 2022

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background and purpose Stroke recognition at the Emergency Medical Services (EMS) impacts the stroke treatment and thus the related health outcome. At the EMS Copenhagen 66.2% of strokes are detected by the Emergency Medical Dispatcher (EMD) and in Denmark approximately 50% of stroke patients arrive at the hospital within the time-to-treatment. An automatic speech recognition software (ASR) can increase the recognition of Out-of-Hospital cardiac arrest (OHCA) at the EMS by 16%. This research aims to analyse the potential impact an ASR could have on stroke recognition at the EMS Copenhagen and the related treatment. Methods Stroke patient data (n = 9049) from the years 2016–2018 were analysed retrospectively, regarding correlations between stroke detection at the EMS and stroke specific, as well as personal characteristics such as stroke type, sex, age, weekday, time of day, year, EMS number contacted, and treatment. The possible increase in stroke detection through an ASR and the effect on stroke treatment was calculated based on the impact of an existing ASR to detect OHCA from CORTI AI. Results The Chi-Square test with the respective post-hoc test identified a negative correlation between stroke detection and females, the 1813-Medical Helpline, as well as weekends, and a positive correlation between stroke detection and treatment and thrombolysis. While the association analysis showed a moderate correlation between stroke detection and treatment the correlation to the other treatment options was weak or very weak. A potential increase in stroke detection to 61.19% with an ASR and hence an increase of thrombolysis by 5% in stroke patients calling within time-to-treatment was predicted. Conclusions An ASR can potentially improve stroke recognition by EMDs and subsequent stroke treatment at the EMS Copenhagen. Based on the analysis results improvement of stroke recognition is particularly relevant for females, younger stroke patients, calls received through the 1813-Medical Helpline, and on weekends. Trial registration This study was registered at the Danish Data Protection Agency (PVH-2014-002) and the Danish Patient Safety Authority (R-21013122).

show abstract

“…Caller stroke recognition and spontaneous mention of stroke signs and symptoms have previously been associated with improved call-taker stroke recognition. It was suggested that this was due to improved public education on stroke [ 26 ]. While it is not known what the South African public's stroke education is, education campaigns through the media could likely improve this, and ultimately aid call-taker stroke recognition.…”

Section: Discussionmentioning

confidence: 99%

The barriers and facilitators to the telephonic application of the FAST assessment for stroke in a private emergency dispatch centre in South Africa

Mackay

Theron

Stassen

2021

African Journal of Emergency Medicine

View full text Add to dashboard Cite

The effect and associated factors of dispatcher recognition of stroke: A retrospective observational study

Abstract: The dispatchers should spend more time identifying stroke patients by following the dispatch protocol. Recognition of stroke by dispatchers was associated with improved stroke care.

Cited by 11 publications

References 15 publications

Stroke mimics: incidence, aetiology, clinical features and treatment

Stroke mimics: incidence, aetiology, clinical features and treatment

Artificial intelligence in Emergency Medical Services dispatching: assessing the potential impact of an automatic speech recognition software on stroke detection taking the Capital Region of Denmark as case in point

The barriers and facilitators to the telephonic application of the FAST assessment for stroke in a private emergency dispatch centre in South Africa

Contact Info

Product

Resources

About