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The following is a summary of “Reducing time delays and enhancing reperfusion eligibility related to stroke suspicion by the Emergency Medical Dispatch Centre: a registry-based observational study,” published in the March 2025 issue of Emergency Medicine Journal by Leto et al. 

Researchers conducted a retrospective study to examine how accurate suspicions by Norwegian Emergency Medical Dispatch Centres influenced clinical care times for individuals with acute ischemic stroke (AIS).  

They analyzed clinical care time metrics and acute reperfusion treatment data from the Norwegian Stroke Registry for individuals with AIS in Western Norway evaluated by the Emergency Medical Dispatch Centre (EMDC) and transported by ambulance in 2021. When the EMDC suspected a stroke, dispatchers relayed their diagnosis suspicions to ambulance personnel. Key outcomes included reperfusion treatment for AIS, prehospital and in-hospital time-to-treatment delays, and individual outcomes.  

The results showed that out of 1,106 individuals with AIS in the region, 771 (70%) met the inclusion criteria. The EMDC suspected a stroke in 481 cases (62%). Stroke suspicion was linked to shorter ambulance on-scene times (11 min vs 15 min; P=0.001), Emergency Medical Service prehospital times (40 min vs 49 min; P=0.021), and door-to-needle times (23 min vs 31 min; P=0.023). After adjusting for age, sex, risk factors, and functional status before the stroke, EMDC suspicion increased thrombolysis rates (OR 2.42 (95% CI 1.72 to 3.40)). Among those receiving endovascular treatment, door-to-groin puncture times were shorter with stroke suspicion (65 min vs 85 min; P =0.004). No significant differences were found in National Institutes of Health Stroke Scale scores at hospital arrival (4 vs 4; P=0.42) or in 90-day functional independence rates (modified Rankin Scale score 0–2; 240 (61%) vs 160 (66%); P=0.24).  

Investigators concluded that accurate EMDC stroke recognition reduced treatment times and increased thrombolysis rates, though dispatcher identification gaps highlighted the need for improved training and tools. 

Source: emj.bmj.com/content/early/2025/03/06/emermed-2024-214294