Published Online
on March 20, 2003

A more recent version of this article appeared on April 1, 2003

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Submitted on October 24, 2002
Accepted on November 1, 2002

Emergency Calls in Acute Stroke

René Handschu MD^*; Reinhard Poppe; Joachim Rauß; Bernhard Neundörfer MD, PhD; and Frank Erbguth MD, PhD

From the Department of Neurology, Friedrich-Alexander-Universitaet Erlangen-Nürnberg, Erlangen (R.H., B.N.); Bavarian Red Cross, Nürnberg EMS Dispatch Center, Nürnberg (R.P., J.R.); and Department of Neurology, City General Hospital, Nürnberg (F.E.), Germany.

^* To whom correspondence should be addressed. E-mail: rene.handschu{at}neuro.med.uni-erlangen.de.

Background and Purpose--In the last 10 years, stroke has become a medical emergency. Subsequently, early recognition of stroke symptoms and rapid activation of the medical system are essential. We sought to investigate what witnesses or victims of an acute stroke syndrome recognize and report in the actual situation.

Methods--We analyzed the recordings of all patients admitted to our stroke unit via the Emergency Medical System (EMS) dispatch center in Nuremberg within 1 year. With a structured evaluation form, the calls were screened for symptoms reported and for any diagnosis or other facts mentioned spontaneously or in response to a question by the dispatcher. We also evaluated data about EMS response and patient condition on admission.

Results--Of 482 patients treated in our stroke unit, 141 calls were evaluated. Main symptoms reported included speech problems (25.5%), motor deficits (21.9%), and disturbances of consciousness (14.8%). In many cases, a fall (21.2%) was presented as the main problem. Sensory deficits (7.8%) and vertigo (5.6%) were rarely mentioned. In 28 calls (19.8%), stroke was mentioned as a possible cause of the acute health problems. The dispatcher suspected a stroke in 51.7% of all cases.

Conclusions--This is one of the first studies to investigate emergency calls in acute stroke. We found that motor deficits and speech problems were the most dramatic symptoms that led to activation of the EMS. Other symptoms were less frequently reported, or atypical descriptions were given. Educational efforts are needed to improve recognition of atypical stroke symptoms by stroke victims and EMS professionals.

Key words: diagnosis • education • emergency medical services • signs and symptoms • stroke, acute

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