Comparative Evaluation of Stroke Triage Algorithms for Emergency Medical Dispatchers

Pilot Prospective Cohort to Determine the Comparative Diagnostic Accuracy of Card 28 to Card 28 and Cincinnati Stroke Scale.

This study will compare the diagnostic accuracy of Card 28 stroke protocol to Card 28 and Cincinnati Stroke Scale, when used by emergency medical dispatchers to interrogate a 911 call suggestive of stroke.

The authors hypothesize that a combination of Card 28 plus the Cincinnati Stroke Scale (CSS) will improve the diagnostic accuracy of emergency medical dispatchers for stroke.

Inclusion Criteria:

1. All 911 calls transferred by local Public Service Answering Points (PSAPs) to the County Communication center of Santa Clara County where the emergency medical dispatchers complete the interrogation using MPDS protocols.
2. All 911 calls received directly at the County Communication center of Santa Clara County where emergency medical dispatchers complete the interrogation using the MPDS protocols.
3. All 911 calls received from subjects (patient) aged > 18 years or second party calls (by-stander or family who are in close proximity to the patient and can administer the tool) by subjects > 18 years of age.

Exclusion Criteria:

1. All calls that require immediate response (ECHO level determinant for life threatening conditions) and emergency medical dispatchers cannot complete Card 28

2. Calls answered by emergency medical dispatchers who have not completed training on the use of Cincinnati Stroke Scale.

3. Calls originating from the cities of Palo Alto, Mountain View, Sunnyvale, Santa Clara, and San Jose that are not interrogated by the County Communication Center for Santa Clara County.

4. 911 calls with no available outcomes in the final discharge database.

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