ArticleBritish paramedic journal2021
Ambulance service call handler and clinician identification of stroke in North East Ambulance Service.
Article in British paramedic journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do interventions to improve the efficiency of acute stroke care affect prehospital times? A systematic review and narrative synthesis.BMC emergency medicine · 2022Pooled it
- Practitioner, patient and public views on the acceptability of mobile stroke units in England and Wales: A mixed methods study.PloS one · 2025Article
- Methods for improving the identification of acute stroke during ambulance calls: A scoping review.PloS one · 2025Article
- "Smart Emergency Call Point" Enhancing Emergency Medical Services on University Campuses.Prehospital and disaster medicine · 2024Article
- Results of an international survey on the status of prehospital care.International journal of stroke : official journal of the International Stroke Society · 2023Article
- What factors contribute towards ambulance on-scene times for suspected stroke patients? An observational study.European stroke journal · 2023Observational
- Defining a threshold above which an adult can be considered to frequently use ambulance services: a retrospective cross-sectional study of emergency calls to an ambulance service in England.British paramedic journal · 2023Article
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionEmergency medical services (EMS) are the first point of contact for most acute stroke patients. The EMS response is triggered by ambulance call handlers who triage calls and then an appropriate response is allocated. Early recognition of stroke is vital to minimise the call to hospital time as the availability and effectiveness of reperfusion therapies are time dependent. Minimising the pre-hospital phase by accurate call handler stroke identification, short EMS on-scene times and rapid access to specialist stroke care is vital. The aims of this study were to evaluate stroke identification by call handlers and clinicians in North East Ambulance Service (NEAS) and report on-scene times for suspected stroke patients.
methodsA retrospective service evaluation was conducted linking routinely collected data between 1 and 30 November 2019 from three sources: NEAS Emergency Operations Centre; NEAS clinicians; and hospital stroke diagnoses.
resultsThe datasets were linked resulting in 2214 individual cases. Call handler identification of acute stroke was 51.5% (95% CI 45.3-57.8) sensitive with a positive predictive value (PPV) of 12.8% (95% CI 11.4-14.4). Face-to-face clinician identification of stroke was 76.1% (95% CI 70.4-81.1) sensitive with a PPV of 27.4% (95% CI 25.3-29.7). The median on-scene time was 33 (IQR 25-43) minutes, with call handler and clinician identification of stroke resulting in shorter times.
conclusionThis service evaluation using ambulance data linked with national audit data showed that the sensitivity of NEAS call handler and clinician identification of stroke are similar to figures published on other systems but the PPV of call handler and clinician identification stroke could be improved. However, sensitivity is paramount while timely identification of suspected stroke patients and rapid transport to definitive care are the primary functions of EMS. Call handler identification of stroke appears to affect the time that clinicians spend at scene with suspected stroke patients.
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