Matthew McKinnon
Optimizing Dispatch Systems for Stroke Management: A Comprehensive Review
Authors: Holden Wagstaff, MD
Department: College of Medicine/Emergency Medicine
A. Background/Purpose
Stroke is a leading cause of death and disability globally, with mortality rates rising over the past decade.¹ Timely stroke treatment is crucial, relying on the stroke chain of survival. However, 22-46% of EMS responses for stroke fail to meet required time guidelines.² Dispatch systems are vital in the early identification of stroke patients, enabling the activation of stroke-specific medical responses.
B. Methods
A comprehensive search strategy was employed to identify relevant studies, with PubMed, EMBASE, and the Cochrane Library databases searched using specific keywords and MeSH descriptors. This search yielded 803 results, narrowed down to 193 articles through inclusion and exclusion criteria.
C. Results
Current dispatch protocols for stroke detection show significant variability in criteria and procedures, resulting in inconsistent sensitivity and specificity, often with low overall accuracy.³,⁴ Accurate stroke identification by dispatchers leads to substantial improvements in process measures and outcomes. Early identification correlates with shorter times to stroke unit arrival, CT scan, and thrombolysis administration,⁵,⁶ while delayed identification is linked to increased mortality risks.⁶
Technological advancements like telemedicine, Helicopter EMS, and Mobile Stroke Units can enhance stroke care through real-time consultations,⁷ rapid transport,⁸ and pre-hospital diagnosis and treatment.⁷ These technologies depend on early and accurate stroke detection.
D. Conclusions
This review highlights the crucial role of dispatch systems in stroke management, calling for further research to refine protocols. Future studies should focus on data analysis, identifying dispatcher challenges, and exploring opportunities for improvement.
