Recognition of stroke symptoms indicative of anterior circulation large-vessel occlusion via telephone and video calls: a simulation study.

Background: Identifying suspected anterior circulation large-vessel occlusion (aLVO) strokes during emergency calls could enhance dispatch efficiency, particularly in rural areas. However, data on emergency medical dispatchers' (EMDs) ability to recognize aLVO symptoms remain limited. This simulation study aimed to evaluate the feasibility of identifying side-specific arm paresis, side-specific conjugate eye deviation (CED), and aphasia during emergency calls by instructing layperson callers to perform brief, standardized examination steps. Two communication methods were compared: (1) telephone calls and (2) video calls.

Methods: Forty-eight laypersons interacted with simulated patients presenting various stroke syndromes. Simulated EMDs conducted standardized assessments during simulated emergency calls, guiding laypersons through patient examinations.

Results: In 96 telephone-assisted and 95 video-assisted calls, EMDs identified aLVO stroke symptoms with high accuracy. In telephone calls, accuracy was 0.92 for side-specific arm paresis, 0.98 for side-specific CED, and 0.88-0.99 for aphasia. In video calls, accuracy was 0.97 for side-specific arm paresis, 0.97 for side-specific CED, and 0.94-1.00 for aphasia.

Conclusions: These findings suggest that EMDs can identify stroke symptoms indicative for aLVO via both telephone and video calls using a standardized dispatch protocol to guide lay bystanders. This study provides a foundation for future real-world research on implementing aLVO detection protocols in emergency dispatch.