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Knowledge Of Symptoms/Action Plan Critical For Stroke Patients And Families
A DGReview of :"Determinants of Use of Emergency Medical Services in a Population With Stroke Symptoms: The Second Delay in Accessing Stroke Healthcare (DASH II) Study"
Stroke
11/03/2000
By Anne MacLennan
Awareness among patients and their families of the urgency of stroke symptoms and of how patients get to hospital may make the difference between recovery and disability following stroke, two studies suggest.
It is imperative that people at high risk of stroke and also their friends and families are alerted to the importance of stroke symptoms and of calling 911 for emergency transport to hospital, one study warns.
Patients were more likely to use emergency services in this study if someone close to them identified a problem and made the call, these authors note.
This study investigated the link between use of emergency medical services and delay time among patients with stroke symptoms. It also examined predictors of emergency medical services (EMS) use.
EMS use was found to be associated with decreased pre-hospital and in-hospital delay. Those who used EMS had a median pre-hospital delay time of 2.85 hours versus 4.03 hours for those who did not.
Older people were more likely to use emergency services, as were those who expressed a high sense of urgency about their symptoms.
Although the advent of time-dependent thrombolytic therapy for ischemic stroke has made it increasingly important for patients to arrive at hospital quickly, delays within emergency departments, as well as patient delays, are also a major factor in lack of use of this therapy, a second study notes.
Nevertheless, use of EMS is an important, modifiable determinant of delay time for treatment of acute stroke, this second multi-centre, prospective study also found.
Among more than 1,000 stroke patients in this study, patients who arrived by EMS had significantly shorter pre-hospital delay times and times to computed tomography scan than did those who did not use EMS. Age, race, sex and educational level did not appear to affect pre-hospital delay times.
Related Link: Prehospital and Emergency Department Delays After Acute Stroke.
"Determinants of Use of Emergency Medical Services in a Population With Stroke Symptoms: The Second Delay in Accessing Stroke Healthcare (DASH II) Study"
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