Article Text

Download PDFPDF

27 Prehospital stroke code. Experience in an argentinean emergency medical service
  1. A Apesteguía1,
  2. A Savia1,
  3. A Farías1,
  4. A Muller2,
  5. M Kamijo2,
  6. C Yaryour2,
  7. E Sorkin2,
  8. M Allende2
  1. 1ACUDIR Emergencias Médicas, Buenos Aires, Argentina
  2. 2OSDE Obra Social de Ejecutivos y Personal de Dirección de Empresas, Argentina


Background Stroke is a time dependent medical emergency1 that requires the coordinated action of the pre and in-hospital teams to improve the results.2 We present the epidemiological characteristics of the population requesting medical attention to a private EMS identified by the telephone operator with activation of a Prehospital Stroke Code (PSC).

Method Observational, retrospective, cross-sectional and descriptive study based on records made through the App Stroke Code v1.0 (internal development) from 01/09/2018 to 31/1/2019. n=97 cases. The data was transferred to a Microsoft Excel spreadsheet and to Epi Info v7.2.2.1 for analysis.

Results PSC was activated in 97 cases. 58 has a suspected Stroke and in 39, the code was canceled by on-scene-EMS team due alternative prehospital diagnosis. The mean age was 78 y/o. 44patients (76%) consulted within three hours of the onset of symptoms. CINCINATTI-prehospital scale average on arrival was 2 points. 100% of patients with CINCITATTI 0–1 consulted after 3 hs (15) (p0.03). On patients with CINCINATTI-score of 3, 97% (p.0038) were hypertensive at the time of the consultation. No hypoglycaemia was found. Of the 58 suspected stroke cases, 16 received some form of reperfusion treatment (rTPA IV, thrombectomy-intraarterial rTPA or combination). The remainder 43 patients who did not receive reperfusion treatment were mainly due to: Alternative in-hospital diagnosis, out of therapeutic window and Intracranial bleeding. The average door to needle time was 37 minutes.

Conclusion Patients more symptomatic consulted earlier 27% of the patients received reperfusion therapy, dramatically surpassing the average of our country (1% according to the RENACER registry3).


  1. Saver JL. Time Is Brain - Quantified. Stroke 2006;37:263–266.

  2. Caputo LM, Jensen J, Whaley M, et al. How a CT-Direct Protocol at an American Comprehensive Stroke Center Led to Door-to-Needle Times Less Than 30 Minutes. The Neurohospitalist 2017, Vol. 7(2) 70–73.

  3. Sposato LA, Esnaola MM, Zamora R and the ReNACer Investigators. Quality of ischemic stroke care in emerging countries: the Argentinian National Stroke Registry (ReNACer). Stroke 2008 Nov;39(11):3036–41.

Conflict of interest None.

Funding None.

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:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.