Feasibility of a Pre-Hospital Notification System Using Direct Calls from Paramedics of 119 EMS Ambulances for Acute Stroke Patients: Accuracy of Diagnosis and Efficacy of Shortening of Door-to-Imaging Time

Background: A pre-hospital notification (PN) system is required to optimize government-initiated comprehensive stroke center (CSC) programs in South Korea. We accordingly conducted a feasibility study in the Busan region. Methods: We determined the stroke detection accuracy and the door-to-imaging (DTI) time as a result of using PN in the Busan region among acute stroke (AS) patients who were diagnosed by paramedics of the Busan 119 Emergency medical service (EMS). All paramedics of 119 EMS were trained using the Cincinnati Pre-hospital Stroke Screen. Beginning in 2011, stroke team members received direct calls from paramedics notifying them of suspected AS patients. Stroke identification results from paramedics were compared with emergency department and final hospital discharge diagnoses. Finally, we compared the DTI time between patients with and without PN by paramedics of the Busan 119 EMS. Results: During the observation period, 91 suspected AS patients were referred to our CSC from paramedics of the Busan 119 EMS. Among them, 57 patients (62.6%) were diagnosed with AS. Their mean DTI time was 13.4 ± 8.1 min. The accuracy rate was similar and imaging time was significantly shorter (32.7 ± 252.8 min, p<0.01), as compared to patients diagnosed by ER doctors during the same period. Conclusion: In this study, we confirmed the feasibility of successful implementation of a PN system for AS patients in the Busan region. J Neurocrit Care 2015;8(2):98-102