Nearly a quarter of hospital or healthline operators mistakenly routed a caller describing classic stroke symptoms to primary care doctors rather than to 9-1-1, according to a research project published in Stroke.

Researchers at Cabell Huntington Hospital in Huntington, WV, found that many of their patients were transferred to their facility more than three hours after their symptom onset, sometimes as late as days after their symptoms started, and many said they called their local hospitals, only to be told that they should contact their primary care doctors instead of calling 9-1-1.

The team identified hospitals in the United States that offer neurology residencies which they thought would be the best at treating stroke and properly handling patients calling with stroke symptoms. One researcher called the hospitals’ main numbers or the help lines that many hospitals offer for medical advice, identified himself as a researcher to the 46 help lines that participated, and described this stroke scenario: a 65-year-old man experiencing weakness in the left arm and leg and having trouble speaking.

The operators were asked which of these four responses they would give to such a person: wait for symptom resolution, contact a primary care physician, drive to a local urgent care center, or call 9-1-1 for ambulance transport. While 78 percent gave the correct answer to call 9-1-1, nearly a quarter of those surveyed said they would tell the person to call their primary care doctor.

The investigators plan to conduct similar surveys with primary care physicians to determine the percentage of doctors that recognize symptoms and route patients to the ED. They will also research responses from 9-1-1 dispatchers and health maintenance organizations.

Source: Emergency Medicine News:Volume 30(1)January 2008p 9