Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND: Rapid access to emergency medical services (EMS) is essential at the onset of acute stroke, but significant delays in contacting EMS often occur. OBJECTIVE: To explore factors that influence the caller's decision to contact EMS at the onset of stroke, and the caller's experiences of the call. METHODS: Participants were identified through a purposive sample of admissions to two hospitals via ambulance with suspected stroke. Participants were interviewed using open-ended questions and content analysis was undertaken. RESULTS: 50 participants were recruited (median age 62 years, 68% female). Only one of the callers (2%) was the patient. Two themes were identified that influenced the initial decision to contact EMS at the onset of stroke: perceived seriousness, and receipt of lay or professional advice. Two themes were identified in relation to the communication between the caller and the call handler: symptom description by the caller, and emotional response to onset of stroke symptoms. CONCLUSIONS: Many callers seek lay or professional advice prior to contacting EMS and some believe that the onset of acute stroke symptoms does not warrant an immediate 999 call. More public education is needed to improve awareness of stroke and the need for an urgent response.

Original publication




Journal article


Emerg Med J

Publication Date





502 - 505


Acute Disease, Adult, Aged, Aged, 80 and over, Decision Making, Emergency Medical Service Communication Systems, England, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Satisfaction, Qualitative Research, Stroke, Surveys and Questionnaires, Young Adult