Evidence map›Paper›PMID 34281596›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021

Emergency medical dispatchers' ability to identify large vessel occlusion stroke during emergency calls.

Pauli E T Vuorinen, Jyrki P J Ollikainen, Pasi A Ketola, Riikka-Liisa K Vuorinen, Piritta A Setälä, Sanna E Hoppu

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Pauli E T VuorinenEmergency Medical Services, Centre for Prehospital Emergency Care, Pirkanmaa Hospital District, Tampere University Hospital, PO Box 2000, FI-33521, Tampere, Finland. pauli.e.vuorinen@pshp.fi.ORCID http://orcid.org/0000-0003-3305-7356
Jyrki P J OllikainenDepartment of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland.
Pasi A KetolaEmergency Medical Services, Centre for Prehospital Emergency Care, Pirkanmaa Hospital District, Tampere University Hospital, PO Box 2000, FI-33521, Tampere, Finland.
Riikka-Liisa K VuorinenFaculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.
Piritta A SetäläEmergency Medical Services, Centre for Prehospital Emergency Care, Pirkanmaa Hospital District, Tampere University Hospital, PO Box 2000, FI-33521, Tampere, Finland.
Sanna E HoppuEmergency Medical Services, Centre for Prehospital Emergency Care, Pirkanmaa Hospital District, Tampere University Hospital, PO Box 2000, FI-33521, Tampere, Finland.
Pirkanmaa Hospital District · FITampere University · FITampere University Hospital · FI

Funding

This research was supported by the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (9V006). 9V006
6 · The paper itself

Abstract

backgroundIn acute ischemic stroke, conjugated eye deviation (CED) is an evident sign of cortical ischemia and large vessel occlusion (LVO). We aimed to determine if an emergency dispatcher can recognise LVO stroke during an emergency call by asking the caller a binary question regarding whether the patient's head or gaze is away from the side of the hemiparesis or not. Further, we investigated if the paramedics can confirm this sign at the scene. In the group of positive CED answers to the emergency dispatcher, we investigated what diagnoses these patients received at the emergency department (ED). Among all patients brought to ED and subsequently treated with mechanical thrombectomy (MT) we tracked the proportion of patients with a positive CED answer during the emergency call.

methodsWe collected data on all stroke dispatches in the city of Tampere, Finland, from 13 February 2019 to 31 October 2020. We then reviewed all patient records from cases where the dispatcher had marked 'yes' to the question regarding patient CED in the computer-aided emergency response system. We also viewed all emergency department admissions to see how many patients in total were treated with MT during the period studied.

resultsOut of 1913 dispatches, we found 81 cases (4%) in which the caller had verified CED during the emergency call. Twenty-four of these patients were diagnosed with acute ischemic stroke. Paramedics confirmed CED in only 9 (11%) of these 81 patients. Two patients with positive CED answers during the emergency call and 19 other patients brought to the emergency department were treated with MT.

conclusionA small minority of stroke dispatches include a positive answer to the CED question but paramedics rarely confirm the emergency medical dispatcher's suspicion of CED as a sign of LVO. Few patients in need of MT can be found this way. Stroke dispatch protocol with a CED question needs intensive implementation.

Indexed as

Emergency Medical DispatcherAgedAged, 80 and overEmergency Medical ServicesFemaleFinlandHumansMaleMiddle AgedOcular Motility DisordersRetrospective StudiesStrokeEmergency medical dispatchEmergency medical servicesLarge vessel occlusion stroke

Identifiers

PMID34281596
PMCPMC8287663
OpenAlexW3183938677

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.