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. 2022 Jun 16;12:10107. doi: 10.1038/s41598-022-14399-0

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Time courses in management of large vessel occlusion patients with or without using a stroke hotline. (A) When emergency medical services (EMS) suspected a patient of having a stroke, the stroke hotline allows the EMS to depart the scene as soon as possible, and they do not need to spend their time searching for a receiving hospital. Medical staff in the hospital are also able to prepare tissue plasminogen activator (t-PA) and endovascular therapy (EVT) based on the prehospital information. Furthermore, we have developed a stroke protocol to shorten the time from the patient’s arrival to stroke treatments. (B) When a patient is not suspected of having a stroke, the EMS need to spend their time at the scene searching for a receiving hospital, leading to a longer prehospital time. Further, after arriving at the hospital, the stroke protocol is not activated until emergency physicians complete their initial assessment of the patient and consult a stroke physician. Consequently, it often takes longer from arrival at the emergency department to undergoing initial stroke care.