Diagnosis and management of stroke before the hospital

This study was carried out as a cross-sectional study for the purpose of evaluating 112 emergency health teams working in the "Aydın 112 Provincial Ambulance Service" dependent to the Ministry of Health, for the correct diagnosis of stroke cases and their interventions before the hospital. Case records of A2 type emergency health stations in the city center of Aydın which were transferred to the hospital were examined in two stages (total: 3482 cases). In the first stage (December / January / February), 1453 case records were examined. According to the data obtained, 112 emergency health teams were educated about the correct diagnosis and management of the stroke before hospital. In the second stage (June / July / August), 2029 case records were examined. The data were obtained by the "Structured questionnaire" prepared by the researcher and the "Cincinnati Prehospital Stroke Scale". Data analyzes were assessed by calculating sensitivity, specificity, accuracy, and positive predictive values. 112 emergency medical teams have been diagnosed with a preliminary diagnosis of stroke in 91 cases in the first stage and 55 cases in the second stage. In the hospital emergency departments, 63 cases were diagnosed with stroke in the first stage and 63 cases were diagnosed with stroke in the second stage. It was determined that strokes were consistent with 69.9% in the first stage and 38.1% in the second stage when the compatibility of stroke diagnosis was checked between the cases diagnosed by 112 emergency health teams and the cases diagnosed in emergency service. The sensitivity of 112 emergency health teams to the correct diagnosis of stroke cases was 64% in the first stage and 38% in the second stage. The Cincinnati Prehospital Stroke Scale used by 112 emergency health teams to pre-diagnose the stroke was found to be 47% sensitive in detecting the stroke. Breathing support, circulatory support, and medical support initiatives to cases with stroke pre-diagnosis were seen to be positively affected after the training period.