title: The role of emergency medical services in stroke: a hospital-based study in Kaohsiung, Taiwan.
abstract: OBJECTIVE
  Emergency medical services (EMS) play an important role in acute stroke therapy. The goal of this study was to investigate the roles and determinants of EMS in stroke in Southern Taiwan, Kaohsiung.
  
  
  METHODS
  We enrolled stroke patients who arrived at emergent department (ED) of the study hospital within 48 hours after the onset of symptoms. Patients were categorized into arriving by EMS or not EMS. Potential determinants of EMS use for stroke were examined by multivariable analyses and the role of EMS in stroke was discussed.
  
  
  RESULTS
  Among 197 stroke patients enrolled, only 44 (22%) patients arrived by EMS at ED. Multivariable logistic regression analysis revealed that the determinants of EMS use were stroke severity measured by NIHSS and non-family member who decided to seek help. Using EMS or not was not associated with the earlier presentation after stroke within 2 hours after attack.
  
  
  CONCLUSIONS
  EMS use was far from sufficient. The transportation time was not the major component of prehospital delay. Both EMS and other vehicles provided prompt delivery. The public should rush to ED either by EMS or other transportation modes when stroke occurred unless use of EMS is proved to provide better outcome in stroke patient in the future study.
authors.affiliation: First Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Chuei-Shiun
authors.initials: CS
authors.lastname: Li
authors.forename: Ku-Chou
authors.initials: KC
authors.lastname: Chang
authors.forename: Teng-Yeow
authors.initials: TY
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000628:therapy*; D014187:Transportation of Patients