ArticleJournal of the American College of Emergency Physicians open2026
Prehospital Use of Lights and Sirens in Stroke Is Associated With Faster Door-to-CT Times but Not Door-to-Thrombolysis or Door-to-Endovascular Therapy Times.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
11 authors.
Funding
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Abstract
Objectives: Lights and sirens (L&S) during Emergency Medical Services (EMS) transport may shorten transport times and improve outcomes in acute stroke but carry significant roadway risk. This study assesses L&S and in-hospital stroke care, including door-to-CT, door-to-intravenous thrombolysis (IVT), door-to-endovascular thrombectomy (EVT), and discharge disposition. Methods: This retrospective cohort study analyzed data from 2020 to 2022, including adult patients identified by EMS as having suspected stroke and who had a final diagnosis of stroke or transient ischemic attack. Data were collected from the IMPACT network (70 EMS agencies, 30 hospitals, 2 states). Multivariable regression modeled the association between L&S and door-to-CT, door-to-IVT, and door-to-EVT times, controlling for confounders. Logistic regression modeled the association between L&S and discharge disposition, adjusting for confounders and in-hospital intervention. Results: Of 3,161 patients, 75.4% (n = 2384) were transported with L&S. Transport time with L&S was shorter than without (geometric mean 8.9 minutes [95% CI 8.7-9.1] vs 11.6 minutes [95% CI 11.0-12.1], Conclusion: While L&S were associated with faster door-to-CT times, they did not shorten time to IVT or EVT or improve discharge outcomes. These findings suggest that perceived urgency of L&S may prompt quicker imaging, but transport time savings are minimal and may not improve outcomes. Alternative EMS prenotification and hospital activation strategies merit consideration.
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