Emergency Medical Services dispatcher recognition of stroke: A systematic review

Purpose: Stroke treatments are time-sensitive, and thus early and correct recognition of stroke by Emergency Medical Services is essential for outcomes. This is particularly important with the adaption of mobile stroke units. In this systematic review, we therefore aimed to provide a comprehensive o...

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Bibliographic Details
Published in:European Stroke Journal 2024-06, Vol.9 (2), p.283-294
Main Authors: Wenstrup, Jonathan, Hestoy, Bartal Hofgaard, Sagar, Malini Vendela, Blomberg, Stig Nikolaj Fasmer, Christensen, Hanne, Christensen, Helle Collatz, Kruuse, Christina
Format: Article
Language:English
Subjects:
Emergency Medical Dispatcher
Emergency Medical Services - methods
Emergency Medical Services - standards
Humans
Review
Stroke - diagnosis
Stroke - therapy
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Summary:Purpose: Stroke treatments are time-sensitive, and thus early and correct recognition of stroke by Emergency Medical Services is essential for outcomes. This is particularly important with the adaption of mobile stroke units. In this systematic review, we therefore aimed to provide a comprehensive overview of Emergency Medical Services dispatcher recognition of stroke. Methods: The review was registered on PROSPERO and the PRISMA guidelines were applied. We searched PubMed, Embase, and Cochrane Review Library. Screening and data extraction were performed by two observers. Risk of bias was assessed using the QUADAS-2 instrument. Findings: Of 1200 papers screened, 24 fulfilled the inclusion criteria. Data on sensitivity was reported in 22 papers and varied from 17.9% to 83.0%. Positive predictive values were reported in 12 papers and ranged from 24.0% to 87.7%. Seven papers reported specificity, which ranged from 20.0% to 99.1%. Six papers reported negative predictive value, ranging from 28.0% to 99.4%. In general, the risk of bias was low. Discussion: Stroke recognition by dispatchers varied greatly, but overall many patients with stroke are not recognised, despite the initiatives taken to improve stroke literacy. The available data are of high quality, however Asian, African, and South American populations are underrepresented. Conclusion: While the data are heterogenous, this review can serve as a reference for future research in emergency medical dispatcher stroke recognition and initiatives to improve prehospital stroke recognition. Graphical abstract
ISSN:2396-9873
2396-9881
2396-9881
DOI:10.1177/23969873231223339