Having a stroke? Make 911 your first call
NEW YORK (Reuters Health) - People who think they're having a stroke, and their loved ones, often call others for advice before calling an ambulance, hints a study conducted in Australia. This could lead to delays in the administration of potentially life-saving treatment.
Half of stroke patients or the people with them at the time of the stroke consulted a third-party, who frequently came to the patient's home before calling an ambulance, Dr. Ian Mosley of the National Stroke Research Institute in Heidelberg Heights, Victoria and colleagues report.
"Knowledge of the benefits of immediately calling an ambulance may reduce pre-hospital delays more than symptom recognition alone," Mosley and his team write in the journal Stroke.
The clot-busting drug alteplase is "highly effective," the researchers note, when given within three hours of a stroke. But just 3 percent of stroke patients in Australia receive this medication, largely because they don't get to the hospital in time.
To investigate what factors were associated with promptly calling an ambulance after a stroke, Mosley and colleagues looked at 198 stroke patients transported to one of three hospitals in Melbourne over six months.
Calls were made within one hour of symptom onset for 52 percent of patients, the researchers found. Callers identified stroke as the problem in 44 percent of cases, and recognized the problem as stroke after prompting in 47 percent of cases.
Callers were most likely to report the problem as a stroke if the patient suffered facial droop or had a history of stroke or "mini-strokes."
But only 22 percent of callers recognized the problem as a stroke and made the call for an ambulance within an hour after symptoms first appeared.
The most common person to make a call was the patient's daughter, in 29 percent of cases, while the patient made the call him or herself in just 3 percent of cases, the researchers found. The patient was alone when the stroke occurred in 20 percent of cases. Eighty percent of the patients were at home at the time of the stroke, while 9 percent were in residential care.
Half the time, the researchers found, the patient or the person with them at the time of the stroke called a third party before calling the ambulance. And in 56 percent of these cases, this individual came to the patient's home before making the ambulance call, even when he or she recognized the problem as a stroke.
Requesting such third-party advice often delayed treatment, the researchers note.
"Agreement among family members to act immediately may remove the need to consult others before calling an ambulance for stroke," they write. "Family members should know that if contacted for advice in an emergency that the best response is to call an ambulance."
SOURCE: Stroke, February 2007.
