# Investigation of symptoms in emergency medical calls by patients treated with thrombectomy: a retrospective study in Western Norway

## TL;DR

This study analyzed emergency calls from stroke patients in Norway to identify common symptoms reported before receiving thrombectomy treatment.

## Contribution

The study highlights speech disturbance as the most commonly reported symptom during emergency calls for stroke patients eligible for thrombectomy.

## Key findings

- Speech disturbance was reported in 79% of emergency calls for stroke patients.
- Callers often failed to recognize facial palsy compared to emergency department assessments.
- Emergency dispatchers asked about FAST symptoms in 57% of calls, with speech being the most common focus.

## Abstract

Patients with large vessel occlusion (LVO) may benefit from endovascular thrombectomy (EVT). Early identification and potential transfer to a comprehensive stroke centre can be advantageous, depending on geographical and logistical factors. This study aimed to describe symptoms reported by the caller for patients during emergency medical calls who had acute stroke and later underwent EVT, aiming to guide further research.

This retrospective descriptive study enrolled patients treated with EVT at Haukeland University Hospital (HUH) who had a primary emergency call to the Bergen Emergency Medical Communication Centre (EMCC) in 2019 and 2021. Patients undergoing EVT were included if they made their first call to the Bergen EMCC. Symptoms presented during the emergency call were quantified and categorised.

Sixty-seven patients were treated with EVT and had their emergency call audio logs recorded at the Bergen EMCC. The most frequently mentioned symptom was speech disturbance (79% of the calls), with 75% of these cases being mentioned spontaneously. Patients were reported conscious in 60% of the calls, 43% had facial palsy, and 36% were reported as having fallen or being found lying on the floor. Emergency medical dispatchers (EMDs) asked about at least one ‘talk, smile, raise arms’ or Face-Arm-Speech-Time (FAST) symptom in 57% of the calls, with questions about speech being the most common (55%).

During emergency medical calls for acute stroke, speech disturbance was the most commonly reported symptom in patients with stroke. A substantial discrepancy was found between the recognition of facial palsy by callers, and that noted in the emergency department (ED), with callers not identifying it as often as the ED. These findings might emphasise the need for enhanced training of emergency medical dispatchers (EMDs) to better recognise and report key stroke symptoms during emergency calls; additionally, they highlight symptoms of particular relevance in emergency calls for patients who are eligible for EVT, an area that should be explored in future research.