CC BY-NC-ND 4.0 · J Neurosci Rural Pract 2017; 08(S 01): S033-S036
DOI: 10.4103/jnrp.jnrp_2_17
Original Article
Journal of Neurosciences in Rural Practice

Prehospital Management of Acute Stroke in Rural versus Urban Responders

Gregory Hansen
Department of Pediatrics, Division of Critical Care, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada
,
Simerpreet Bal
1  Department of Clinical Neurosciences, Division of Neurology, University of Calgary, Calgary, Alberta T2N 2T9, Canada
,
Kerri Lynn Schellenberg
2  Department of Medicine, Division of Neurology, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada
,
Susan Alcock
3  Department of Medicine, Health Sciences Centre, Section of Neurology, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada
,
Esseddeeg Ghrooda
3  Department of Medicine, Health Sciences Centre, Section of Neurology, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada
› Author Affiliations
Further Information

Publication History

Publication Date:
03 September 2019 (online)

ABSTRACT

Objective: Stroke guideline compliance of rural Canadian prehospital emergency medical services (EMS) care in acute stroke is unknown. In this quality assurance study, we sought to compare rural and urban care by prehospital EMS evaluation/management indicators from patients assessed at an urban Canadian stroke center.Materials and Methods: One hundred adult patients were randomly selected from the stroke registry. Patients were transported through Rural EMS bypass protocols or urban EMS protocols (both bypass and direct) to our stroke center between January and December 2013. Patients were excluded if they were first evaluated at any other health center. Prehospital care was assessed using ten indicators for EMS evaluation/management, as recommended by acute stroke guidelines. Results: Compliance with acute stroke EMS evaluation/management indicators were statistically similar for both groups, except administrating a prehospital diagnostic tool (rural 31.8 vs. urban 70.3%; P = 0.002). Unlike urban EMS, rural EMS did not routinely document scene time. Conclusion: Rural EMS responders' compliance to prehospital stroke evaluation/management was similar to urban EMS responders. Growth areas for both groups may be with prehospital stroke diagnostic tool utilization, whereas rural EMS responders may also improve with scene time documentation.