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Targets for improvi...
Targets for improving dispatcher identification of acute stroke
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Mattila, O. S. (författare)
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Puolakka, T. (författare)
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Ritvonen, J. (författare)
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visa fler...
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Pihlasviita, S. (författare)
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Harve, H. (författare)
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Alanen, A. (författare)
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Sibolt, G. (författare)
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Curtze, S. (författare)
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Strbian, D. (författare)
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Pystynen, M. (författare)
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- Tatlisumak, Turgut (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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Kuisma, M. (författare)
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Lindsberg, P. J. (författare)
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(creator_code:org_t)
- 2019-02-13
- 2019
- Engelska.
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 14:4, s. 409-416
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Accurate identification of acute stroke by Emergency Medical Dispatchers (EMD) is essential for timely and purposeful deployment of Emergency Medical Services (EMS), and a prerequisite for operating mobile stroke units. However, precision of EMD stroke recognition is currently modest. Aims: We sought to identify targets for improving dispatcher stroke identification. Methods: Dispatch codes and EMS patient records were cross-linked to investigate factors associated with an incorrect dispatch code in a prospective observational cohort of 625 patients with a final diagnosis of acute stroke or transient ischemic attack (TIA), transported to our stroke center as candidates for recanalization therapies. Call recordings were analyzed in a subgroup that received an incorrect low-priority dispatch code indicating a fall or unknown acute illness (n = 46). Results: Out of 625 acute stroke/TIA patients, 450 received a high-priority stroke dispatch code (sensitivity 72.0%; 95% CI, 68.5-75.5). Independent predictors of dispatcher missed acute stroke included a bystander caller (aOR, 3.72; 1.48-9.34), confusion (aOR, 2.62; 1.59-4.31), fall at onset (aOR, 1.86; 1.24-2.78), and older age (aOR [per year], 1.02; 1.01-1.04). Of the analyzed call recordings, 71.7% revealed targets for improvement, including failure to recognize a Face Arm Speech Time (FAST) test symptom (21/46 cases, 18 with speech disturbance), or failure to thoroughly evaluate symptoms (12/46 cases). Conclusions: Based on our findings, efforts to improve dispatcher stroke identification should primarily focus on improving recognition of acute speech disturbance, and implementing screening of FAST-symptoms in emergency phone calls revealing a fall or confusion.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Stroke
- dispatcher identification
- EMS
- emergency call
- acute ischemic-stroke
- thrombolysis
- care
- Neurosciences & Neurology
- Cardiovascular System & Cardiology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Mattila, O. S.
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Puolakka, T.
-
Ritvonen, J.
-
Pihlasviita, S.
-
Harve, H.
-
Alanen, A.
-
visa fler...
-
Sibolt, G.
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Curtze, S.
-
Strbian, D.
-
Pystynen, M.
-
Tatlisumak, Turg ...
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Kuisma, M.
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Lindsberg, P. J.
-
visa färre...
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Göteborgs universitet