The Recognition-Response Gap in Acute Stroke: Examining the Relationship between Stroke Recognition and Response in a General Population Survey

Reliability of Bystander Recognition of Clinical Features in Pre-Hospital Classification of Acute Cerebrovascular Syndromes: Preliminary Findings

“…This unfortunate fact may be due to a reduced sensitivity of the medical staff or an inadequate hospital infrastructure 11,18,19 . In the ICH and SAH cases, we detected a lower final onset-to-door time, probably because the clinical presentation of these stroke types is usually perceived as more severe 11,12 . We also found that a direct arrival (without detours in other medical institutions) and having an age of 65 years or older are factors associated with a shorter final onset-to-door time and that an indirect arrival before definite referral to our centers was associated with a higher probability of in-hospital death.…”

“…The recognition of an acute stroke may vary among different populations [10][11][12][13][14] . The communication between the EMS personnel and the bystander witnessing an acute cerebrovascular emergency with preestablished methods has improved clinical outcomes in other countries 3,12,15 .…”

“…The recognition of an acute stroke may vary among different populations [10][11][12][13][14] . The communication between the EMS personnel and the bystander witnessing an acute cerebrovascular emergency with preestablished methods has improved clinical outcomes in other countries 3,12,15 . The in-hospital outcome of stroke patients might improve by identifying a neurovascular emergency correctly, regardless of its final etiology 4,5,12,16,17 .…”

“…The communication between the EMS personnel and the bystander witnessing an acute cerebrovascular emergency with preestablished methods has improved clinical outcomes in other countries 3,12,15 . The in-hospital outcome of stroke patients might improve by identifying a neurovascular emergency correctly, regardless of its final etiology 4,5,12,16,17 . Our objective was to determine the feasibility and impact of pre-hospital clinical rules to determine the type of stroke, to assess if CPRs could be used by the EMS personnel to implement rapid treatment strategies, especially for reperfusion therapy of AIS.…”

“…Older age was associated with a 5-fold increased probability of early arrival, possibly due to increased stroke severity in elderly individuals and a known history of vascular risk factors 20,21 . Seeking medical evaluation in the presence of an acute focal neurological deficit is usually fast, even when those manifestations are not necessarily identified as caused by an acute stroke 1,2,12 . Validated pre-hospital clinical rules already exist 16,17,[22][23][24] , and our study did not aim to create new ones.…”