title: Effects of comprehensive education protocol in decreasing pre-hospital stroke delay among Chinese urban community population.
abstract: OBJECTIVE
  Studies have shown that awareness of early stroke symptoms and the use of ambulances are two important factors in decreasing pre-hospital stroke delay. The purpose of this study is to evaluate a comprehensive educational stroke protocol in improving stroke response times.
  
  
  METHODS
  Two urban communities in Beijing (population ≍50 000), matched in economic status and geography, were enrolled in this study. A comprehensive educational protocol, which included public lectures and distribution of instructive material for the community and its medical staff, was implemented from August 2008 to December 2010. Surveillance of new onset stroke in both communities was carried out during the same period. Pre-hospital delay time and percentage of patients using emergency medical services (EMS) were compared between the two communities.
  
  
  RESULTS
  After comprehensive educational protocol, we found that: (i) pre-hospital delay (time from stroke symptom onset to hospital arrival) decreased from 180 to 79 minutes, (ii) the proportion of patients arriving within three hours of stroke onset increased from 55·8% to 80·4%, (iii) pre-hospital delay of stroke patients with symptoms of paralysis, numbness, and speech impediments was decreased, and (iv) the proportion of stroke patients calling for EMS increased from 50·4% to 60·7%.
  
  
  CONCLUSIONS
  The comprehensive educational stroke protocol was significantly effective in decreasing pre-hospital stroke delay.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shengyun
authors.initials: S
authors.lastname: Chen
authors.forename: Haixin
authors.initials: H
authors.lastname: Sun
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.forename: Paul
authors.initials: P
authors.lastname: Fu
authors.forename: Wang
authors.initials: W
authors.lastname: Yan
authors.forename: Wang
authors.initials: W
authors.lastname: Yilong
authors.forename: Jia
authors.initials: J
authors.lastname: Hongyan
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yan
authors.forename: Wang
authors.initials: W
authors.lastname: Wenzhi
mesh_terms: D000328:Adult; D044466:Asian People / Q000193:education*; D042241:Early Diagnosis; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D006266:Health Education; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D015397:Program Evaluation; D020521:Stroke / Q000175:diagnosis*; D013997:Time Factors; D014505:Urban Population