Video-call Assisted Assessment of Acute Stroke in Addition to Stroke Severity Scales in a Prehospital Setting

Video-call Assisted Assessment of Acute Stroke in Addition to Stroke Severity Scales in a Prehospital Setting: A Cluster Randomised Pilot Trial

This study aims to investigate whether a live stream video between the on-call neurologist and the emergency medical services is feasible.

Multiple stroke severity scales have been coined in order to examine patients suspected of stroke in a prehospital setting in order to identify and transfer patients eligible for thrombectomy directly to a comprehensive stroke centre (CSC). However, performance and feasibility vary greatly in different validation studies suggesting that those outcomes are greatly dependent on other factors i.e. acceptance amongst stakeholders, implementation process, patient segment etc. Some recent studies have shown promising results using telemedicine i.e. video solutions between emergency medical services (EMS) personnel and on-call neurologist in examining patients suspected of stroke in the prehospital phase. The investigators will perform this trial to examine whether a cluster randomised trial with video call assisted assessment of patients suspected of stroke in a prehospital setting is an appropriate trial design and feasible with regard to recruitment and retention, acceptability among stakeholders (EMS and neurologists) as well as patients and lastly with regard to stakeholders' adherence to protocol.

Inclusion Criteria:

• Suspected stroke within 24 hours from onset (confirmed with Pre-hospital stroke score 1 ≥1)
• Catchment area of Hospital Sønderjylland
• Deferred informed consent obtained from patient or patient surrogate

Exclusion Criteria:

• In-hospital stroke or private transport to hospital
• Unconsciousness defined as Glascow Coma Score (GCS) ≤ 8 (as they cannot be rated)