The Role of Doctors in Ambulance Management of Stroke Patients in Emergency Medical Services

Korakot Apiratwarakul; Artit Boonrod; Nontaphon Piyawattanametha; Kamonwon Ienghong; Darunee Sripadungkul; Somsak Tiamkao; Lap Woon Cheung

doi:10.3889/oamjms.2022.8922

Authors

Korakot Apiratwarakul Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-1984-0865
Artit Boonrod Department of Orthopedic, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Nontaphon Piyawattanametha Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Kamonwon Ienghong Department of Emergency Medicine
Darunee Sripadungkul Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Somsak Tiamkao Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Lap Woon Cheung Department of Accident and Emergency, Princess Margaret Hospital, Kowloon, Hong Kong; Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong

DOI:

https://doi.org/10.3889/oamjms.2022.8922

Keywords:

Stroke, Cerebrovascular accident, Prehospital emergency care, Emergency care, Physicians

Abstract

BACKGROUND: Strokes are one of the most common of all neurological diseases and can be found in all genders and ages. Emergency medical services (EMS) are the first line of care with access to stroke patients from on the scene assessment to initial treatment. However, currently there are no studies regarding the role doctors play in initial ambulance contact to assess stroke patients.

AIM: To analyze the role of doctors in ambulances managing stroke patients in EMS.

METHODS: This was a retrospective study over a five-year period (2017-2021) at Srinagarind Hospital EMS units. The information from the EMS database was transferred completely into the data record form and imported into the computer system for further data analysis.

RESULTS: A total of 10,329 EMS operations were examined. The mean age of the patients was 52.10 ± 10.24 years. A total of 64.4% (n = 6650) of them were male. The afternoon shift was the most common time for EMS operations with doctors in the stroke group (42.9%) and non-stroke group (59.3%). The distance from hospital to the scene in the stroke group was 12.6 ± 3.2 km. The average response time for stroke group and non-stroke group were 7.05 minutes and 9.50 minutes, respectively

CONCLUSIONS: The role of doctors in the ambulance to manage stroke patients in EMS directly resulted in a decrease in time in arriving at the scene to diagnose, arriving at the laboratory, and arriving at the scene to activate the special team.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Caprio FZ, Sorond FA. Cerebrovascular disease: Primary and secondary stroke prevention. Med Clin North Am. 2019;103(2):295-308. https://doi.org/10.1016/j.mcna.2018.10.001 PMid:30704682 DOI: https://doi.org/10.1016/j.mcna.2018.10.001

Knight-Greenfield A, Nario JJQ, Gupta A. Causes of acute stroke: A patterned approach. Radiol Clin North Am. 2019;57(6):1093-108. https://doi.org/10.1016/j.rcl.2019.07.007 PMid:31582037 DOI: https://doi.org/10.1016/j.rcl.2019.07.007

Hathidara MY, Saini V, Malik AM. Stroke in the young: A global update. Curr Neurol Neurosci Rep. 2019;19(11):91. https://doi.org/10.1007/s11910-019-1004-1 PMid:31768660 DOI: https://doi.org/10.1007/s11910-019-1004-1

Das AS, Regenhardt RW, Feske SK, Gurol ME. Treatment approaches to lacunar stroke. J Stroke Cerebrovasc Dis. 2019;28(8):2055-78. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.05.004 PMid:31151838 DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.05.004

Apiratwarakul K, Suzuki T, Phengsavanh A, Wangsri K. Learning outcomes of an international training course on mechanical cardiopulmonary resuscitation device use for emergency medicine residents. J Med Assoc Thai. 2021;104(Suppl 1):S12-5. https://doi.org/10.35755/jmedassocthai.2021.S01.12134 DOI: https://doi.org/10.35755/jmedassocthai.2021.S01.12134

Apiratwarakul K, Celebi I, Tiamkao S, Bhudhisawasdi V, Pearkao C, Ienghong K. Understanding of development emergency medical services in laos emergency medicine residents. Open Access Maced J Med Sci. 2021;9(E):1085-91. https://doi.org/10.3889/oamjms.2021.7333 DOI: https://doi.org/10.3889/oamjms.2021.7333

Apiratwarakul K, Suzuki T, Celebi I, Tiamkao S, Bhudhisawasdi V, Gaysonsiri D, et al. Emergency medical services amid new wave of coronavirus disease 2019 outbreak in Khon Kaen, Thailand. Open Access Maced J Med Sci. 2021;9(E):492-5. https://doi.org/10.3889/oamjms.2021.6243 DOI: https://doi.org/10.3889/oamjms.2021.6243

Apiratwarakul K, Ruamsuk P, Suzuki T, Celebi I, Tiamkao S, Bhudhisawasdi V, et al. Development of emergency medical services amid 5 years’ experience at a medical school in Thailand. Open Access Maced J Med Sci. 2021;9(E):378-81. https://doi.org/10.3889/oamjms.2021.6075 DOI: https://doi.org/10.3889/oamjms.2021.6075

Noorian AR. Prehospital EMS triage for acute stroke care. Semin Neurol. 2021;41(1):5-8. https://doi.org/10.1055/s-0040-1722725 PMid:33506476 DOI: https://doi.org/10.1055/s-0040-1722725

Lu YX, Li SD, Shan GL, Peng B. Association between intention to call EMS in stroke patients and level of hospital classification and emergency medical service usage among stroke patients in China. Neurol Neurochir Pol. 2021;55(6):582-91. https://doi.org/10.5603/PJNNS.a2021.0083 PMid:34783353 DOI: https://doi.org/10.5603/PJNNS.a2021.0083

Prabhakaran S, Richards CT, Kwon S, Wymore E, Song S, Eisenstein A, et al. A community-engaged stroke preparedness intervention in Chicago. J Am Heart Assoc. 2020;9(18):e016344. https://doi.org/10.1161/JAHA.120.016344 PMid:32893720 DOI: https://doi.org/10.1161/JAHA.120.016344

Goldberg SA, Cash RE, Peters G, Weiner SG, Greenough PG, Seethala R. The impact of COVID-19 on statewide EMS use for cardiac emergencies and stroke in Massachusetts. J Am Coll Emerg Physicians Open. 2021;2(1):e12351. https://doi.org/10.1002/emp2.12351 PMid:33532755 DOI: https://doi.org/10.1002/emp2.12351

Alabdali A, Yousif S, Alsaleem A, Aldhubayb M, Aljerian N. Can emergency medical services (EMS) shorten the time to stroke team activation, computed tomography (CT), and the time to receiving antithrombotic therapy? A prospective cohort study. Prehosp Disaster Med. 2020;35(2):148-51. https://doi.org/10.1017/S1049023X20000126 PMid:32054556 DOI: https://doi.org/10.1017/S1049023X20000126

Mayampurath A, Parnianpour Z, Richards CT, Meurer WJ, Lee J, Ankenman B, et al. Improving prehospital stroke diagnosis using natural language processing of paramedic reports. Stroke. 2021;52(8):2676-9. https://doi.org/10.1161/STROKEAHA.120.033580 PMid:34162217 DOI: https://doi.org/10.1161/STROKEAHA.120.033580

Hawkes MA, Gomez-Schneider MM, Dossi DE, Melcon MO, Ameriso SF. Stroke knowledge in the EstEPA project, a populationbased study. J Stroke Cerebrovasc Dis. 2021;30(2):105471. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105471 PMid:33242783 DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105471