Fire Engine Support and On-scene Time in Prehospital Stroke Care – A Prospective Observational Study. Issue 3 (28th March 2016)

• Record Type: Journal Article
• Authors: Puolakka, Tuukka; Väyrynen, Taneli; Erkkilä, Elja-Pekka; Kuisma, Markku
• Is Part Of: Prehospital and disaster medicine. Volume 31:Issue 3(2016)
• Page Start: 278
• Page End: 281
• Publication Date: 2016-03-28
• Subjects: Emergency Medical Services, -- stroke, -- time factors; Emergency medical services -- Periodicals; Emergency medicine -- Periodicals; Disaster medicine -- Periodicals; 616.025
• DOI: 10.1017/S1049023X16000303
• Languages: English
• ISSNs: 1049-023X

Abstract

Abstract: Introduction: On-scene time (OST) previously has been shown to be a significant component of Emergency Medical Services' (EMS') operational delay in acute stroke. Since stroke patients are managed routinely by two-person ambulance crews, increasing the number of personnel available on the scene is a possible method to improve their performance. Hypothesis: Using fire engine crews to support ambulances on the scene in acute stroke is hypothesized to be associated with a shorter OST. Methods: All patients transported to hospital as thrombolysis candidates during a one-year study period were registered by the ambulance crews using a case report form that included patient characteristics and operational EMS data. Results: Seventy-seven patients (41 [53%] male; mean age of 68.9 years [SD=15]; mean Glasgow Coma Score [GCS] of 15 points [IQR=14-15]) were eligible for the study. Forty-five cases were managed by ambulance and fire engine crews together and 32 by the ambulance crews alone. The median ambulance response time was seven minutes (IQR=5-10) and the fire engine response time was six minutes (IQR=5-8). The number of EMS personnel on the scene was six (IQR=5-7) and two (IQR=2-2), and the OST was 21 minutes (IQR=18-26) and 24 minutes (IQR=20-32; P =.073) for the groups, respectively. In a following regression analysis, using stroke as the dispatch code was the only variable associated with short (<22 minutes) OST with an odds ratio of 3.952 (95% CI, 1.279-12.207). Conclusion: Dispatching fire engine crews to support ambulances in acute stroke care was not associated with a shorter on-scene stay when compared to standard management by two-person ambulance crews alone. Using stroke as the dispatch code was the only variable that was associated independently with a short OST. T Puolakka, T Väyrynen, E-P Erkkilä, M Kuisma .Fire engine support and on-scene time in prehospital stroke care – a prospective observational study .Prehosp Disaster Med .2016 ;31 (3 ):278 –281 .