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Fire Engine Support and On-scene Time in Prehospital Stroke Care – A Prospective Observational Study

Published online by Cambridge University Press:  28 March 2016

Tuukka Puolakka ,
Taneli Väyrynen ,
Elja-Pekka Erkkilä  and
Markku Kuisma
Tuukka Puolakka*
Affiliation:
Section of Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Taneli Väyrynen
Affiliation:
Section of Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Department of Emergency Medicine, Vaasa Central Hospital, Vaasa, Finland
Elja-Pekka Erkkilä
Affiliation:
Tampere Area Rescue Department, City of Tampere, Finland
Markku Kuisma
Affiliation:
Section of Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
*
Correspondence: Tuukka Puolakka, MD Section of Emergency Medical Services Department of Emergency Medicine Helsinki University Hospital & University of Helsinki P.O. Box 112, FIN-00099 City of Helsinki, Finland E-mail: tuukka.puolakka@hus.fi
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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.

PuolakkaT , VäyrynenT , ErkkiläE-P , KuismaM . Fire Engine Support and On-scene Time in Prehospital Stroke Care – A Prospective Observational Study. Prehosp Disaster Med. 2016;31(3):278–281.

Keywords

Emergency Medical Servicesstroketime factors
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 3 , June 2016 , pp. 278 - 281
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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