{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T16:14:34Z","timestamp":1774023274968,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001734","name":"Copenhagen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Scand J Trauma Resusc Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification and correct triage of stroke in the prehospital setting are essential for timely treatment and improved outcomes. In Region Zealand, Denmark, ambulance personnel are instructed to consult a neurologist when stroke is suspected to facilitate direct admission to a specialised stroke unit. However, little is known about what happens when emergency medical service (EMS) dispatchers correctly suspect stroke, but the patient is not admitted directly to a stroke unit. This includes whether a consultation with a neurologist occurs and on what basis patients are rejected. The primary aim was to determine how often ambulance personnel consulted with a neurologist and examine documented reasons for not referring patients directly to a stroke unit. The secondary aim was to describe symptom presentation in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study linked prehospital ambulance records, Computer-Aided Dispatch data, and the Danish Stroke Register. The prehospital medical record by ambulance personnel was reviewed for each case to examine the decision-making during ambulance responses using a predefined instrument. The study included patients\u2009\u2265\u200918\u00a0years who were initially suspected of having a stroke by the EMS dispatcher, were not transported directly to a stroke unit, and a stroke diagnose in the Danish Stroke Register corresponding to the same clinical event from January 2021 to September 2024 in Region Zealand, Denmark. Descriptive statistics were used to summarise findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 680 patients included, 583 (86%) were consulted with a neurologist. Patients consulted with a neurologist were older (median 77 vs. 74\u00a0years; p\u2009=\u20090.021) and more often exhibited typical stroke symptoms such as paresis and aphasia. Reasons for neurologist rejection were documented in 201 out of 583 consulted patients (34%) and included being outside the thrombolysis time window (19%), contraindications to thrombolysis (15%), few or atypical stroke symptoms (14%), or lack of suspicion of stroke (12%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While most patients were consulted with a neurologist, a notable proportion were not despite instructions. Reasons for rejection was documented in 34% of patients and included being outside the thrombolysis time window, contraindications, or atypical symptoms. These findings highlight the need to review triage instructions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13049-026-01579-4","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T01:45:52Z","timestamp":1770947152000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prehospital stroke triage in Denmark: a retrospective observational study of emergency medical services handling confirmed stroke cases not admitted directly to a stroke unit"],"prefix":"10.1186","volume":"34","author":[{"given":"Astrid Merete Blomberg","family":"Drej\u00f8e","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Glerup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troels","family":"Wienecke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Wenstrup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix Nicolai","family":"Raben-Levetzau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi Shil","family":"Eddelien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stig Nikolaj Fasmer","family":"Blomberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helle Collatz","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"1579_CR1","doi-asserted-by":"publisher","unstructured":"Kuriakose D, Xiao Z. 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