Recognition of visual symptoms in stroke: a challenge to patients, bystanders, and Emergency Medical Services

BMC Emergency Medicine

Research

Christina Kruuse¹  Kristina Parsberg Berg²  Viktor Frederik Idin Sørensen²  Stig Nikolaj Fasmer Blomberg³  Helle Collatz Christensen⁴ 

[1] Department of Neurology, Copenhagen University Hospital - Herlev Gentofte, Copenhagen, Denmark;Department of Neurology, Copenhagen University Hospital - Herlev Gentofte, Copenhagen, Denmark;Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, 2750, Copenhagen, Denmark;Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, 2750, Copenhagen, Denmark;Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, 2750, Copenhagen, Denmark;Danish Clinical Quality Program (RKKP), National Clinical Registries, Copenhagen, Denmark;Emergency Medical Services Region Zealand, Naestved, Denmark;

关键词: Stroke;    Visual symptoms;    Prehospital;    Emergency Medical Services;    stroke recognition;   

DOI  :  10.1186/s12873-023-00870-2

 received in 2023-01-07, accepted in 2023-08-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIdentification of visual symptoms as a sign of acute stroke can be challenging for both first line healthcare professionals and lay persons. Failed recognition of visual symptoms by medical dispatchers at the Emergency Medical Dispatch Center (EMDC-112) or personnel at the Out-of-Hours Health Service (OOHS) may delay stroke revascularization. We aimed to identify correct system response to visual symptoms in emergency calls.MethodsPhone calls from patient or bystander to the EMDC-112 or OOHS, which included visual symptoms on patients later verified with stroke/Transient ischemic attack (TIA) diagnosis, were analyzed. Data were stratified according to hospitalization within and after 4.5 h from symptom onset. Descriptive and multiple logistic regression analysis were performed.ResultsOf 517 calls identified, 290 calls fulfilled inclusion criteria. Only 30% of the patients received correct visitation by the medical dispatchers and referral to the hospital by a high-priority ambulance. Correct visitation was associated with early contact (adjusted OR: 2.37, 95% CI: 1.11, 5.03), contact to the EMDC-112 (adjusted OR: 3.18, 95% CI: 1.80, 5.62), and when the medical dispatcher asked additional questions on typical stroke symptoms (adjusted OR: 6.36, 95% CI: 3.01, 13.43). No specific visual symptom was associated with stroke recognition and fast hospitalization.ConclusionsFirst line healthcare professionals had significant problems in identifying visual symptoms as a sign of acute stroke and eliciting correct response. This highlights an urgent need to improve knowledge of visual symptoms in acute stroke and emphasize correct response to stroke symptoms in general.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2