Wisconsin Coverdell Stroke Program: Emergency Medical Services
In the United States, stroke remains a leading cause of death and serious long-term disability. Long-term effects can include paralysis, speech impairments, and other serious health issues. EMS (emergency medical services) workers play a critical role in a patient’s survival
Stroke and EMS
When 911 is called for a stroke patient, EMS is involved in the care and transport of that patient. EMS providers play a crucial role in helping people survive and in reducing long-term disabilities. It’s important for local EMS providers to know how to identify stroke victims. They need to make quick and accurate decisions on the care of the stroke patient, and determine the best hospital for care.
Unfortunately, less than one-half of all stroke patients in Wisconsin arrive at the emergency department by ambulance. EMS providers can play a huge role in educating the community. The public needs to recognize early warning signs of a stroke and the importance of calling 911.
In an effort to reach the goals outlined above, the Wisconsin Coverdell Stroke Program invites EMS agencies to become Coverdell EMS Partners. EMS Partners are recognized on the Wisconsin Coverdell Stroke Program website. They receive a press release template for local publicity.
The benefits of being a Coverdell EMS Partner include:
- Quarterly data reports on stroke measure performance.
- Invitations for education and training.
- Access to community education outreach materials.
- Quarterly EMS meetings that offer networking, review of Coverdell and Wisconsin stroke metrics, and sharing of best practices.
- Recognition on the state stroke program website.
- Satisfaction in advancing your knowledge and skills to benefit your community and your patients.
Interested in partnering with the Wisconsin Coverdell Stroke Program? Fill out the Coverdell Emergency Medical Services (EMS) Partner Agreement, F-01647 (PDF)
Participating EMS providers
- Aspirus Wausau Hospital MedEvac
- Boscobel Rescue Squad, Inc.
- Butler Volunteer Fire Department
- Caledonia Fire Department
- City of Appleton Fire Department
- City of Beloit Fire Department
- City of Fond du Lac Fire Rescue
- City of Madison Fire Department
- City of Oshkosh Fire Department
- City of Pewaukee Fire Department
- City of Waukesha Fire Department
- Clinton Fire Protection District
- De Pere Fire Rescue
- Deer–Grove EMS District
- Door County Emergency Medical Service
- Eagle River Memorial Hospital Ambulance Service
- Fitch–Rona EMS District
- Footville Fire Department EMS
- Howard Young Medical Center Ambulance Oneida County EMS
- Greenfield Fire Department
- Kenosha Fire Department
- Lakes Region EMS, Inc.
- Lauderdale La Grange Fire Department
- Lincoln County EMS - Tomahawk
- Marquette County EMS – Montello Branch
- Marshfield Fire & Rescue Department
- Menomonee Falls Fire Department
- Milwaukee Fire Department
- Muscoda Rescue Squad
- Oneida County Ambulance - Rhinelander
- Oneida County Ambulance - Three Lakes
- Oregon Area Fire EMS District
- Potosi Rescue Squad
- Poynette Dekorra Emergency Medical Service
- Racine Fire Department
- Raymond Fire and Rescue Department
- Reedsburg Area Ambulance Service
- Riverside Fire District
- South Area Fire and Emergency Response District
- Southwest Health EMS
- South Shore Fire Department
- Sparta Area Ambulance
- Sun Prairie Emergency Medical Service
- Taylor County EMS
- Tomah Area Ambulance Service
- Town of Beloit Fire Department
- Town of Brookfield Fire Department
- Wausau Fire Department
- Waushara County EMS – Wautoma Division
- West Allis Fire Department
- Wisconsin Rapids Fire Department
When someone calls 911, emergency medical dispatch should be able to identify potential acute stroke patients. Preferably, this is done through a medical priority dispatch system during the 911 call. Identifying a potential stroke patient allows for the right EMS dispatch and hospital destination.
EMS providers should:
- Assess the patient using a validated pre-hospital stroke scale (for example, Cincinnati, Los Angeles, BE FAST).
- Obtain a blood glucose level.
- Get a 12-lead electrocardiogram (ECG), if available.
- Decide the best hospital destination based on ability to care for an acute stroke patient.
- Report their assessment findings before arriving at that hospital.
The Importance of EMS Pre-Notification, P-03132 (PDF)—Pre-notification should occur so emergency staff can prepare for the arrival of the acute stroke patient. Effective communication gives the emergency department time to activate its stroke team. This allows rapid triage of the incoming stroke patient. Plain language communication using terms such as “Stroke Alert” or “Neuro Alert” can enhance the care the stroke patient receives at the hospital. Hospitals and EMS should collaborate on education and protocols for acute stroke patient care.
EMS providers are the front-line health care providers. They can recognize stroke and decrease the long-term disabilities caused by an acute stroke.
Participating EMS data is submitted to and queried from the Wisconsin Ambulance Runs Data System (WARDS). Measures are determined in accordance with guidelines from the American Heart Association. These provide the foundation for stroke care quality improvement in Wisconsin:
- EMS on-scene time recorded
- Stroke screening performed and documented as a vital sign
- Neuro exam, stroke screening, or Glasgow scale documented as a vital sign
- Percent of runs transported to a designated stroke center
- EMS left scene within 15 minutes of arriving to patient
- Situation last known well (LKW) time entered
- Situation LKW and patient arrived at destination were both entered
- Percent of stroke patients who arrived at hospital within 3.5 hours of time LKW
- Blood glucose documented as a vital sign
- Stroke runs with hospital pre-notification documentation
- Record complete with blood glucose, stroke scale, and on-scene time
EMS partners meet virtually for 1 hour each quarter. The meeting provides opportunities for partners to network with fellow EMS as well as ask questions and share best practices. The meeting consists of:
- Reviewing blinded data across the stroke systems of care (SSoC) to identify areas where efficiency and quality of care can be improved
- Updates on hospital practices
- Information on stroke-related activities at the state level
Articles and guidelines
- The Importance of an Accurate Last Known Well and Symptom Onset Time, P-02469 (PDF)
- The Importance of EMS Pre-Notification, P-03132 (PDF)
EMS support
Maps
- Drive Time to Coverdell Program Hospitals, P-03353b (PDF)
- Drive Time to Hospital Stroke Centers, P-03353d (PDF)
- Wisconsin EMS Service Center Locations
- Wisconsin Coverdell EMS Service and Hospital Partners, P-03353 (PDF)
- Wisconsin Coverdell Program EMS Services, P-03353a (PDF)
- Wisconsin Coverdell Stroke Program: Stroke Transfer Map
Videos
EMS for Stroke: The First Line of Defense—Video for EMS services regarding pre-hospital care. Includes identifying stroke, assessing hospital stroke capabilities by certification level, and routing protocols.
Professional development resources
- Paramedic career path online guide - This guide provides an in-depth look at the path to becoming a paramedic, including the necessary education, certifications, and skills required. It highlights the critical role paramedics play in emergency medical services, offering life-saving care in communities' most crucial moments. With insights into the daily challenges and rewards of the job, this resource aims to inspire and inform those interested in pursuing this noble career.
- Top paramedic programs
- Take the online training on Wisconsin Stroke Recognition for EMS Providers. This training focuses on stroke recognition and treatment for the EMS provider. The Wisconsin Coverdell Stroke Program created and offers this training. Participants earn one hour of continuing education credit.
Resilience for first responders
Resilience is the ability to adapt and recover from adversity. Resilience matters within ourselves, our relationships, and in our communities. Find healthy ways to cope with trauma and toxic stress, especially during tough times, take a step closer to becoming more resilient.
Resilient Wisconsin is here to help. The program offers the latest mental and behavioral health self-care tools and trauma-informed practices.
Success stories
View all of the Coverdell Stroke Program's Success Stories on the Coverdell Community page. View success stories, such as:
- Getting to the Right Place First: Milwaukee County EMS Stroke Patient Transport
- Enhancing Emergency Department Efficiency Decreases Patient Disposition Times
- Strong Partnership Leads to Increased Documentation of EMS Pre-notification: City of West Allis Fire Department and Advocate Aurora West Allis Medical Center
If partners have quality improvement projects, best practice, or partnerships they would like to share, Coverdell can discuss highlighting your organization’s achievements. Contact Kyleen.Maccoux@dhs.wisconsin.gov if you have any questions or would like to be the next Wisconsin Coverdell Stroke Program Success Story.
Community stroke education
View all of the Coverdell Stroke Program's stroke education materials the Coverdell Community page.
Contact us
Ka Z Xiong, MPH
Coverdell Epidemiologist and Program Director
Ka.Xiong@dhs.wisconsin.gov