Too Many Stroke Victims Fail to Use EMS for Fastest
Trip to Treatment
Ethnic minorities, rural residents least likely to
call 911 at onset of a stroke as recommended by American Heart
April 30, 2013 — Time is critical to stroke victims
but more than a third don’t get to the hospital by ambulance, even
though that’s the fastest way to get help, according to new research in
Circulation: Cardiovascular Quality and Outcomes, an American
Heart Association journal.
Researchers studied records on more than 204,000
stroke patients arriving at emergency rooms at 1,563 hospitals
participating in the American Heart Association/American Stroke Get With
The Guidelines-Stroke quality improvement program in
Emergency medical services (EMS) transported 63.7
percent of the patients, with the rest arriving in various other ways,
During a stoke emergency, quick treatment is
critical. EMS transported 79 percent of those who got to the hospital
within two hours of the start of their symptoms.
That resulted in earlier arrival, quicker
evaluation and faster treatment, said the researchers who found:
● Almost 61 percent of people transported by
EMS got to the hospital within three hours of the first symptoms,
compared to 40 percent who didn’t use EMS;
● Almost 55 percent using EMS had a brain scan
within 25 minutes of hospital arrival, compared to 35.6 percent who
didn’t use EMS;
● Of patients eligible for a clot-busting drug,
67.3 percent using EMS received it within three hours of symptom onset,
compared to 44.1 percent who didn’t use EMS.
“EMS are able to give the hospital a heads up, and
that grabs the attention of the emergency room staff to be ready to act
as soon as the patient arrives,” said Jeffrey L. Saver, M.D., senior
author of the study and director of the UCLA Comprehensive Stroke Center
in Los Angeles, Calif.
“The ambulance crew also knows which hospitals in
the area have qualified stroke centers. Patients don't lose time going
to one hospital only to be referred to another that can provide more
advanced care if needed, whether that’s drugs to bust up the clot or
device procedures to remove it.”
Minorities and rural residents were less likely to
call for EMS at the signs of a stroke, researchers found.
“A number of factors can fuel the reluctance to
call 9-1-1,” said James Ekundayo, M.D., Dr.P.H., lead author of the
study and assistant professor in the Department of Family and Community
Medicine at Meharry Medical College in Nashville, Tenn.
“People may not recognize symptoms and may delay
seeking medical care or call their doctor instead.
We hear people say they just didn’t want to be a
bother, but many times there could have been a better outcome if EMS had
About 795,000 Americans experience a new or
recurrent stroke each year — a stroke every 40 seconds or a related
death every four minutes.
Boosting public awareness efforts and education is
critical to improving stroke outcomes in the short- and long-term,
The American Heart Association/American Stroke
Together to End Stroke,
sponsored nationally by healthcare products leader Covidien, raises
stroke awareness and educates Americans that stroke is largely
preventable, treatable and beatable.
● Face Drooping –
Does one side of the face droop or is it numb? Ask the person to smile.
● Arm Weakness – Is
one arm weak or numb? Ask the person to raise both arms. Does one arm
● Speech Difficulty
– Is speech slurred, are they unable to speak, or are they hard to
understand? Ask the person to repeat a simple sentence, like “The sky is
blue.” Is the sentence repeated correctly?
● Time to call 9-1-1
– If the person shows any of these symptoms, even if the symptoms go
away, call 9-1-1 and get them to the hospital immediately.
“Your life, your brain, depends on calling 9-1-1,”
Saver said. “Know the signs and act fast if you or someone you’re with
is having stroke symptoms.”
The American Stroke Association has more
Other co-authors are: Gregg C. Fonarow, M.D.; Lee
H. Schwamm, M.D.; Ying Xian, M.D., Ph.D.; Xin Zhao, M.S.; Adrian F.
Hernandez, M.D.; Eric D. Peterson, M.D.; and Eric M. Cheng, M.D. Author
disclosures and funding are noted on the manuscript.
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