Skip to main content
Top
Published in: International Journal of Emergency Medicine 1/2021

Open Access 01-12-2021 | Stroke | Original Research

Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand

Authors: Phantakan Tansuwannarat, Pongsakorn Atiksawedparit, Arrug Wibulpolprasert, Natdanai Mankasetkit

Published in: International Journal of Emergency Medicine | Issue 1/2021

Login to get access

Abstract

Background

This work was to study the prehospital time among suspected stroke patients who were transported by an emergency medical service (EMS) system using a national database.

Methods

National EMS database of suspected stroke patients who were treated by EMS system across 77 provinces of Thailand between January 1, 2015, and December 31, 2018, was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance, and distance to the scene) and prehospital time (i.e., dispatch, activation, response, scene, and transportation time) were extracted. Time parameters were also categorized according to the guidelines.

Results

Total 53,536 subjects were included in the analysis. Most of the subjects were transported during 06.00-18.00 (77.5%) and were 10 km from the ambulance parking (80.2%). Half of the subjects (50.1%) were served by advanced life support (ALS) ambulance. Median total time was 29 min (IQR 21, 39). There was a significant difference of median total time among ALS (30 min), basic (27 min), and first responder (28 min) ambulances, Holm P = 0.009. Although 91.7% and 88.3% of the subjects had dispatch time ≤ 1 min and activation time ≤ 2 min, only 48.3% had RT ≤ 8 min. However, 95% of the services were at the scene ≤ 15 min.

Conclusion

Prehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min.
Appendix
Available only for authorised users
Literature
3.
go back to reference Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46–e110. https://doi.org/10.1161/STR.0000000000000158 Epub 2018 Jan 24.CrossRefPubMed Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46–e110. https://​doi.​org/​10.​1161/​STR.​0000000000000158​ Epub 2018 Jan 24.CrossRefPubMed
8.
go back to reference Acker J, Pancioli A, Crocco T, Eckstein M, Jauch E, Larrabee H, et al. Implementation strategies for emergency medical services within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association Expert Panel on Emergency Medical Services Systems and the Stroke Council. Stroke. 2007;38:3097–115.CrossRef Acker J, Pancioli A, Crocco T, Eckstein M, Jauch E, Larrabee H, et al. Implementation strategies for emergency medical services within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association Expert Panel on Emergency Medical Services Systems and the Stroke Council. Stroke. 2007;38:3097–115.CrossRef
9.
go back to reference Jauch E, Saver J, Adams H, Bruno A, Connors J, Demaerschalk B, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870–947. Jauch E, Saver J, Adams H, Bruno A, Connors J, Demaerschalk B, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870–947.
10.
go back to reference Centers for Disease Control and Prevention (CDC). Prehospital and hospital delays after stroke onset--United States, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007;56(19):474–8. Centers for Disease Control and Prevention (CDC). Prehospital and hospital delays after stroke onset--United States, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007;56(19):474–8.
14.
go back to reference Hanchaiphiboolkul S, Poungvarin N, Nidhinandana S, Suwanwela NC, Puthkhao P, Towanabut S, et al. Prevalence of stroke and stroke risk factors in Thailand: Thai Epidemiologic Stroke (TES) Study. J Med Assoc Thail. 2011;94(4):427–36. Hanchaiphiboolkul S, Poungvarin N, Nidhinandana S, Suwanwela NC, Puthkhao P, Towanabut S, et al. Prevalence of stroke and stroke risk factors in Thailand: Thai Epidemiologic Stroke (TES) Study. J Med Assoc Thail. 2011;94(4):427–36.
16.
go back to reference Bodeepat W, Chatchadaporn O. Development of stroke fast track management in emergency department, Nakhonpathom Hospital. Region 4-5 Med J. 2017;36(4):251–63. Bodeepat W, Chatchadaporn O. Development of stroke fast track management in emergency department, Nakhonpathom Hospital. Region 4-5 Med J. 2017;36(4):251–63.
17.
go back to reference Metta S, Malai S, Jirasuk L, Tuenchai S, Supasin D. Time to access and referral of stroke patients in Thakhuntho Hospital, Thakhuntho District, Kalasin Province. Hahasarakham Hosp J. 2020;17(3):140–7. Metta S, Malai S, Jirasuk L, Tuenchai S, Supasin D. Time to access and referral of stroke patients in Thakhuntho Hospital, Thakhuntho District, Kalasin Province. Hahasarakham Hosp J. 2020;17(3):140–7.
19.
go back to reference Wongwiangjunt S, Komoltri C, Poungvarin N, Nilanont Y. Stroke awareness and factors influencing hospital arrival time: a prospective observational study. J Med Assoc Thail. 2015;98(3):260–4. Wongwiangjunt S, Komoltri C, Poungvarin N, Nilanont Y. Stroke awareness and factors influencing hospital arrival time: a prospective observational study. J Med Assoc Thail. 2015;98(3):260–4.
22.
go back to reference National institute for emergency medicine. Emergency medical triage protocol and criteria basd dispatch. 2nd ed. Bangkok: Ministry of Public Health; 2013. National institute for emergency medicine. Emergency medical triage protocol and criteria basd dispatch. 2nd ed. Bangkok: Ministry of Public Health; 2013.
23.
go back to reference National Institute for Emergency Medicine. Annual report 2015. Bangkok: Ministry of Public Health; 2013. National Institute for Emergency Medicine. Annual report 2015. Bangkok: Ministry of Public Health; 2013.
24.
go back to reference Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6(2):65–70. Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6(2):65–70.
33.
Metadata
Title
Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand
Authors
Phantakan Tansuwannarat
Pongsakorn Atiksawedparit
Arrug Wibulpolprasert
Natdanai Mankasetkit
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Keywords
Stroke
Triage
Care
Published in
International Journal of Emergency Medicine / Issue 1/2021
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1186/s12245-021-00361-w

Other articles of this Issue 1/2021

International Journal of Emergency Medicine 1/2021 Go to the issue

Educational advances in emergency medicine

Impact of an end-of-fourth-year emergency medicine bootcamp