Telecommunicator-assisted first aid in stroke: ensuring completeness and consistency of prearrival instructions

Stroke is a time-sensitive medical emergency in which early recognition of symptoms and prompt bystander intervention can substantially improve survival and neurological outcomes. Providing scripted prearrival instructions (PAI) to callers by emergency telecommunicators over the telephone may expedite and optimize prehospital care. Telecommunicators can guide callers to collect essential information for the arriving emergency medical services personnel and offer immediate first-aid advice to prevent serious complications of stroke. However, despite the anticipated benefits of telecommunicator assistance, both the theoretical foundations and practical implementation of telephone prearrival guidance for stroke remain underexplored. This study systematically developed a comprehensive, evidence-based set of PAI for stroke through structured analysis of international and national first-aid guidelines, stroke management guidelines, and emergency medical services dispatch protocol collections. The resulting synthesized PAI set is proposed for discussion and further refinement within the emergency medicine community, with the ultimate goal of creating a harmonized tool to support telecommunicators in managing suspected stroke incidents.