Authors; Year	Type of Study	Patients	Objective (O)/Conclusion (C)
Golden AP and Odoi A; 2015 [14].	Retrospective observational study	3900 patients	O: study the factors that produce prehospital delays. C: geographic area affects access time.
Gorchs-Molist, Montse et al., 2020 [16].	Observational study	4000 health professionals	O: determine the impact of training health professionals on the stroke code protocol for early recognition. C: the training of health professionals is crucial to avoid delays in response times.
Alabdali, Abdullah et al., 2020 [20].	Prospective cohort study	220 patients	O: demonstrate that transport in the EMS of patients with suspected stroke shortens the time until activation of the stroke team. C: the objective is met.
McKinney, James S et al., 2013 [24].	Comparative study	229 patients	O: demonstrate that PN to hospitals of cases with suspected strokes by EMS reduces evaluation, diagnostic testing, and treatment times. C: PN in hospitals by EMS in stroke cases reduces response times.
Soto-Cámara R et al., 2021 [31].	Systematic review	101 articles	O: analyze the factors that influenced prehospital time in stroke care. C: some factors decrease delays in prehospital time and others increase them.
Al Kasab, Sami et al., 2021 [27].	Comparative study	101 patients	O: evaluate telestroke consultations in EMS equipped with videoconferencing technology. C: telestroke consultations may be the solution to optimize prehospital stroke triage in rural areas and reduce delays in the administration of thrombolytic and endovascular therapies.
Seo, Ah Ram et al., 2021 [17].	Multicenter study	480 patients	O: check the factors that cause a delay in the activation of the EMS. C: prehospital delay occurs mainly due to the population’s difficulty in recognizing stroke symptoms.
Naguib, Rania et al., 2020 [19].	Observational study	600 patients	O: test whether delay in recognizing stroke warning symptoms and seeking medical advice results in delayed treatment and increased morbidity. C: it is important to raise awareness among the population about stroke and the warning symptoms.
Gonzalez-Aquines, Alejandro et al., 2019 [21].	Observational study	189 patients	O: identify the factors associated with the delay in start-to-alarm time. C: it is necessary to carry out education programs for PC physicians to quickly identify a possible stroke.
Cáceres, J Alfredo et al., 2013 [26].	Observational study	52,282 cases	O: demonstrate the importance of good training for medical dispatchers. C: the use of EMS and prehospital notification by paramedics is crucial to reducing prehospital delay.
García Ruiz, Rafael et al., 2018 [22].	Observational study	328 patients	O: identify the factors that cause prehospital delay in patients with stroke. C: stroke awareness is very important, as is knowing the factors that affect prehospital delay.
Cooley, S Regan et al., 2021 [28].	Comparative study	411 patients	O: demonstrate that stroke units improved response times. C: mobile stroke units facilitate prehospital management.
Kim, Dae-Hyun et al., 2016 [25].	Comparative study	274 patients	O: check the impact of prehospital intervention on the delay time until receiving appropriate treatment. C: the use of EMS and prehospital notification by paramedics is crucial to reducing prehospital delay.
Belt, Gary H et al., 2016 [29].	Observational study	111 patients	O: analyze whether telemedicine during patient transport accelerates the stroke treatment process. C: equipped mobile stroke transport units decrease prehospital delay time
Andrew, Benjamin Y et al., 2017 [30].	Comparative study	2589 cases	O: evaluate the effect of using a mobile coordination application for stroke care. C: the use of smartphone technology improves the care of stroke patients.
Puolakka, Tuukka et al., 2016 [23].	Prospective observational study	308 patients	O: analyze the operation of SME. C: recognition of strokes through calling emergency services is crucial to avoid delays in the prehospital phase.
Varjoranta, Tuure et al., 2019 [15].	Retrospective study	232 patients	O: observe the effect of prehospital and hospital delays in stroke patients. C: continuous training of health professionals is very important to avoid prehospital delays, as well as improve transportation, especially in rural areas.
Faiz, Kashif W et al., 2019 [18].	Transversal study	207 patients	O: evaluate whether knowledge of stroke symptoms and risk factors are associated with early hospital admission. C: knowledge of strokes by the population does not lead to knowing how to act in this case.