Association Between Dispatch Complaint and Critical Prehospital Time Intervals in Suspected Stroke 911 Activations in the National Emergency Medical Services Information System, 2012–2016

Journal Article · 23 December 2021 · Journal of Stroke and Cerebrovascular Diseases

DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106228 · OSTI ID:1981695

Abbas, MPH, Amena Y.  ^[1]; Odom, Ph.D., MS, Erika C. ^[1]; Nwaise, Ph.D., MA, Isaac ^[1]

---

1. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States)

Emergency Medical Services can help improve stroke outcomes by recognizing stroke symptoms, establishing response priority for 911 calls, and minimizing prehospital delays. This study examines 911 stroke events and evaluates associations between events dispatched as stroke and critical EMS time intervals. Data from the National Emergency Medical Services Information System, 2012 to 2016, were analyzed. Activations from 911 calls with a primary or secondary provider impression of stroke were included for adult patients transported to a hospital destination. Three prehospital time intervals were evaluated: (1) response time (RT) ≤8 min, (2) on-scene time (OST) ≤15 min, and (3) transport time (TT) ≤12 min. Associations between stroke dispatch complaint and prehospital time intervals were assessed using multivariate regression to estimate adjusted risk ratios (ARR) and 95% confidence intervals (CIs). Approximately 37% of stroke dispatch complaints were identified by EMS as a suspected stroke. Compared to stroke events without a stroke dispatch complaint, median OST was shorter for events with a stroke dispatch (16 min vs. 14 min, respectively). In adjusted analyses, events dispatched as stroke were more likely to meet the EMS time benchmark for OST ≤15 min (OST, 1.20 [1.20–1.21]), but not RT or TT (RT, [1.00–1.01]; TT, 0.95 [0.94–0.95]). Furthermore, our results indicate that dispatcher recognition of stroke symptoms reduces the time spent on-scene by EMS personnel. These findings can inform future EMS stroke education and quality improvement efforts to emphasize dispatcher recognition of stroke signs and symptoms, as EMS dispatchers play a crucial role in optimizing the prehospital response.

• Research Organization: Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
• Sponsoring Organization: USDOE; USDOE Office of Science (SC)
• Grant/Contract Number: SC0014664
• OSTI ID: 1981695
• Journal Information: Journal of Stroke and Cerebrovascular Diseases, Journal Name: Journal of Stroke and Cerebrovascular Diseases Journal Issue: 3 Vol. 31; ISSN 1052-3057
• Publisher: ElsevierCopyright Statement
• Country of Publication: United States
• Language: English