Educational Effect on Prehospital Personnel for Prehospital Stroke Management

ABSTRACT

PURPOSE: If optimal neurologic recovery of stroke patients is to be achieved, thrombolysis and intervention must be initiated within hours from the onset of stroke symptoms. The prehospital personnel play a vital role in prehospital stroke management, including rapid recognition of stroke and rapid transport of the victim to the treating facility. The fact is, however, education and assessment of prehospital personnel's knowledge and practice in recognizing stroke are lacking. In this study, we assessed the prehospital personnel's knowledge of stroke; then, we performed an analysis to determine if that knowledge proved to have an impact on stroke management. METHODS: The study was conducted from March to August 2001 at 9 fire stations in Seoul and other regional areas, and included 164 prehospital personnel. In order to conduct a before-and-after comparative study, we first investigated the prehospital personnel's current knowledge of stroke; then, we administered our own educational training which was taught by an emergency physician. RESULTS: One hundred sixty-four prehospital personnel participated in the educational training program. Most of them (63.4%) were educated at the National Fire Academy. The most frequently listed stroke risk factor was hypertension (98.2%). The most frequently listed stroke symptom and sign was abnormal speech (91.5%). The level of knowledge about the prehospital stroke scale was very low (facial palsy: 10.8%, arm drift: 7.9%, dysarthria: 17.7%). Before the education, their knowledge about the definition of stroke, its risk factors, symptoms and signs, the goal of prehospital management, and the therapeutic window for thrombolysis was not satisfactory. However, there was a significant improvement after the education(p<0.001). The extent of knowledge about stroke varied with the characteristics of the prehospital personnel. The prehospital personnel's knowledge was relatively higher if they were EMP-P certified; from the Department of Emergency Medical Service; worked in Seoul; had been educated for stroke; or had been less than 2 years on the job. CONCLUSION: Presently, the prehospital personnel 's knowledge about prehospital stroke management has proven to be insufficient. However, there was a significant improvement in stroke knowledge after education by an emergency physician