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In this study we explored the use of real-time video streaming for neurologist\u2013EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Video streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient\u2019s legs, arms, language, and facial expressions. The aim of the assessment was to determine appropriate management and transport destination based on the combination of geographical location and severity of stroke symptoms. Two realistic patient scenarios were created, with severe and moderate stroke symptoms, respectively. Each scenario was simulated using a neurologist acting as stroke patient and an ambulance team performing patient assessment. Four ambulance teams with two nurses each all performed both scenarios, for a total of eight cases. All scenarios were video recorded using handheld and fixed cameras. The audio from the video consultations was transcribed. Each team participated in a semi-structured interview, and neurologists and actors were also interviewed. Interviews were audio recorded and transcribed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Analysis of video-recordings and post-interviews (<jats:italic>n<\/jats:italic>\u2009=\u20097) show a more thorough prehospital patient assessment, but longer total on-scene time, compared to a baseline scenario not using video consultation. Both ambulance nurses and neurologists deem that video consultation has potential to provide improved precision of assessment of stroke patients. Interviews verify the system design effectiveness and suggest minor modifications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The results indicate potential patient benefit based on a more effective assessment of the patient\u2019s condition, which could lead to increased precision in decisions and more patients receiving optimal care. The findings outline requirements for pilot implementation and future clinical tests.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-024-02539-7","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T17:02:04Z","timestamp":1717002124000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations"],"prefix":"10.1186","volume":"24","author":[{"given":"Stefan","family":"Candefjord","sequence":"first","affiliation":[]},{"given":"Magnus","family":"Andersson Hagiwara","sequence":"additional","affiliation":[]},{"given":"Bengt Arne","family":"Sj\u00f6qvist","sequence":"additional","affiliation":[]},{"given":"Jan-Erik","family":"Karlsson","sequence":"additional","affiliation":[]},{"given":"Annika","family":"Nordanstig","sequence":"additional","affiliation":[]},{"given":"Lars","family":"Rosengren","sequence":"additional","affiliation":[]},{"given":"Hanna Maurin","family":"S\u00f6derholm","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"2539_CR1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","volume":"20","author":"VL Feigin","year":"2021","unstructured":"Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. 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The research was conducted in accordance with the requirements of the Declaration of Helsinki. Informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants in the study consented orally and in writing to the results, including images showing EMS clinicians and actors representing patients, being published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"146"}}