Awareness and First Aid

ER24’s Contact Centres use a specific protocol to identify stroke cases, which are treated as priority calls.

The earlier you get treatment, the better the outcome.

Correct emergency care

When you call ER24 for help, a specially trained Emergency Resource Officer (ERO) knows how to identify the warning signs of a stroke and will act quickly to handle the emergency. Recognising and telling apart stroke symptoms can be difficult, so the EROs use advanced technology to help them guide emergency calls in the right direction for the best possible response.

“They are trained in asking a series of questions designed to extract relevant information that will trigger the correct course of action – ensuring stroke cases are treated as a priority, and not missed or delayed,” says Sonja Tonkin, Clinical Coordinator at ER24. “These questions might include asking what stroke symptoms the patient is displaying, the time the symptoms started, if they are awake, and if they are able to walk.”

How ER24 identifies stroke symptoms

ER24 uses the international pre-hospital stroke scale (the FAST assessment) to identify patients who have had a stroke. This translates into:

Facial weakness: Can the person smile? Has their mouth or eye drooped? 

Arm weakness: Can the person raise both arms without any weakness? 

Speech problems: Can the person speak clearly and understand what you say?

Time to call 084 124 if any of these signs appear. Note time of symptom onset.

Why time is critical

“If callers alert us correctly, those extra few minutes could be lifesaving, says Sonja. “ The sooner a patient arrives at hospital and their contra-indications for specific therapy is excluded, the more likely it is for a good outcome ”

Warning signs of a future stroke

A transient ischaemic attack (TIA) is a temporary episode of symptoms like those of a stroke. “A TIA usually lasts only a few minutes, but it’s often called a ‘mini stroke’ as it can serve as both a warning of a future stroke and an opportunity to prevent it,” Sonja says. “In the early stages of a TIA, it's not possible to tell whether you're having a TIA or a stroke, so calling 084 124 for real help, real fast is the appropriate course of action.”

Correct clinical pathway for stroke

Once ER24 paramedics arrive on the scene, they are trained to verify the signs of a stroke and kickstart the stroke clinical pathway by getting the patient to the nearest qualifying hospital. Their decision-making is guided by what Dr Melanie Stander, General Manager Clinical Services at Mediclinic Southern Africa, calls the “hub and spoke” concept.

“Hubs are hospitals that can provide the highest level of stroke care – due to the presence of a specialist who has access to advanced imaging to retrieve blood clots in the brain. This improves brain blood flow and limits brain damage. Most other hospitals will be considered spokes: they can provide emergency initial imaging and ongoing treatment and can refer the patient on to a hub hospital as needed.”

The most important thing to remember is that someone who suffers a stroke can often recover if they are treated in time. Don’t waste precious minutes if you suspect someone has stroke symptoms.