Porteous G H, Corry M D, Smith W S
School of Medicine, University of California, San Francisco 94143-0114, USA.
Prehosp Emerg Care. 1999 Jul-Sep;3(3):211-6. doi: 10.1080/10903129908958939.
Certain forms of stroke can be treated if access to medical care is expeditious. Since many stroke victims first enter medical care through emergency medical services (EMS) access, minimizing delays in the EMS system may translate to improved neurologic outcome. Because EMS dispatchers determine the response priority for these calls, dispatchers should be able to recognize the signs and symptoms of stroke based on their brief phone interviews. The authors studied the abilities of dispatchers in a major urban area to correctly identify stroke and transient ischemic attack (TIA) in victims who access 911 and describe what is communicated in the 911 call.
A retrospective review was conducted of the medical records of patients treated for stroke or TIA at two urban hospitals during 1996. The tape-recorded 911 calls from patients using EMS were transcribed and analyzed. Information regarding dispatcher classification and triage of these calls was collected and described.
The records of 182 patients with acute stroke or TIA were reviewed. Fifty-three percent of patients used EMS. Dispatchers coded 31% of their 911 calls as stroke. The word "stroke" was used without prompting by 51% of callers, yet fewer than half of these calls were coded as stroke by dispatchers. Many callers reported symptoms characteristic of stroke, including impaired communication (36%), weakness (30%), and decreased ability to stand or walk (25%). Only 41% of ambulances were sent at high priority.
People who activate EMS for stroke frequently use the word "stroke" and/or describe symptoms compatible with stroke in their calls. EMS dispatch protocols should be sensitive for these symptoms to ensure more accurate and timely ambulance dispatch.
如果能迅速获得医疗救治，某些类型的中风是可以治疗的。由于许多中风患者最初是通过紧急医疗服务（EMS）获得医疗救治的，因此尽量减少EMS系统中的延误可能会改善神经功能结局。因为EMS调度员决定这些呼叫的响应优先级，所以调度员应该能够根据简短的电话访谈识别中风的体征和症状。作者研究了一个大城市地区调度员正确识别拨打911的中风患者和短暂性脑缺血发作（TIA）患者的能力，并描述了911呼叫中传达的信息。
对1996年两家城市医院治疗的中风或TIA患者的病历进行回顾性研究。对使用EMS的患者的911电话录音进行转录和分析。收集并描述有关调度员对这些呼叫的分类和分诊的信息。
回顾了182例急性中风或TIA患者的病历。53%的患者使用了EMS。调度员将他们接到的911呼叫中的31%编码为中风。51%的呼叫者在未被提示的情况下使用了“中风”一词，但这些呼叫中只有不到一半被调度员编码为中风。许多呼叫者报告了中风的典型症状，包括沟通障碍（36%）、虚弱（30%）以及站立或行走能力下降（25%）。只有41%的救护车被优先派出。
因中风拨打EMS的人在呼叫中经常使用“中风”一词和/或描述与中风相符的症状。EMS调度协议应对这些症状保持敏感，以确保更准确、及时地派出救护车。
