Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey.
Cha-Nam Shin, Kyungeh An, Jeongha Sim
PMID 31406718WHAT IT FOUND
Most acute stroke patients in this Korean survey did not call an ambulance, delaying treatment.
Those who called arrived at the hospital in half the time. Patients who first contacted family members did not use ambulances more often than those who did not.
Key findings
01Only about one-third of patients used emergency medical services, and contacting family members first did not increase the likelihood of using an ambulance.
02Patients who used emergency medical services had a median overall prehospital time of 140 minutes, compared to 625 minutes for those who did not.
03Experiencing hemiparesis and recognizing the urgency of symptoms were significant predictors of using emergency medical services.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was drawn from a single regional hospital, limiting the generalizability of the findings to the broader Korean population. Data relied on patient and family recollection of events, which may introduce recall bias, particularly given the stress of the stroke event. The study design is cross-sectional and retrospective, so it cannot prove that using emergency medical services directly caused faster arrival times, only that they are associated.
Declared interests
The authors declared no potential or actual conflicts of interest.
The easy way to misread this
Do not assume that family involvement is a barrier to care. The study found that contacting family members did not statistically reduce the odds of using emergency medical services, but the primary issue was the patients' failure to recognize the urgency of their symptoms.