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242 Large vessel occlusion stroke in an emergency call: A descriptive analysis of emergency calls for thrombectomy candidates
  1. P Vuorinen1,2,
  2. J Kiili1,2,
  3. E Alanko1,2,
  4. H Huhtala3,
  5. J Ollikainen4,
  6. P Setälä2,
  7. S Hoppu2
  1. 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  2. 2Emergency Medical Services, Centre for Prehospital Emergency Care, Department of Emergency, Anaesthesia and Pain Medicine, Tampere University Hospital, Tampere, Finland
  3. 3Faculty of Social Sciences, Tampere University, Tampere, Finland
  4. 4Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland

Abstract

Background Large vessel occlusion strokes cause most of the post-stroke disability and mortality. In this study, we aim to find out common words and phrases used in the emergency calls for paramedic-suspected thrombectomy candidates. Also, we wanted to find out how a question about conjugate eye deviation, an indicator of vast cortical ischemia, arises in the Finnish stroke dispatch protocol.

Method This was a retrospective study with descriptive analysis of emergency calls for patients with paramedic-suspected large vessel occlusion stroke. We listened to the emergency calls for 157 patients transported to a Finnish comprehensive stroke centre.

Results Speech disturbance was the most common symptom brought up in 125 (80%) calls, followed by tripping (n=63, 40%) and facial asymmetry (n=41, 26%). Suspicion of stroke was mentioned by 44 (28%) callers. Inability to speak any words was mentioned in 65 calls (52% of calls with speech disturbance). Otherwise, difficulty to speak was described, for example, as a lisp, mumble or slurred speech. Conjugate eye deviation was definitively heard in 12 emergency calls. Ten of these patients were diagnosed with large vessel occlusion.

Conclusion In the emergency calls for patients with paramedic-suspected large vessel occlusion, typical stroke symptoms were described. The severity of the stroke stood out by the patients’ inability to speak any words or remain standing. It is possible to further develop stroke dispatch protocols to recognise thrombectomy candidates already during an emergency call.

Conflict of interest None.

Funding None.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

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