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LiVE-STROKE: live video from bystander to the medical dispatcher in potential stroke cases.

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Τίτλος: LiVE-STROKE: live video from bystander to the medical dispatcher in potential stroke cases.
Συγγραφείς: Rischel E; Copenhagen Emergency Medical Services, Telegrafvej 5, opg. 2, 3rd Floor, Ballerup, Denmark. elise.egebjerg.rischel.01@regionh.dk., Iversen HK; Department of Neurology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark., Christensen H; Department of Neurology, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark., Wenstrup J; Prehospital Centre, Region Zealand, Næstved, Denmark.; Department of Brain and Spinal Cord Injuries, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark., Christensen HC; Prehospital Centre, Region Zealand, Næstved, Denmark., Linderoth G; Copenhagen Emergency Medical Services, Telegrafvej 5, opg. 2, 3rd Floor, Ballerup, Denmark.; Department of Anaesthesia and Intensive Care, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
Πηγή: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2026 Feb 03; Vol. 34 (1). Date of Electronic Publication: 2026 Feb 03.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 101477511 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-7241 (Electronic) Linking ISSN: 17577241 NLM ISO Abbreviation: Scand J Trauma Resusc Emerg Med Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central
Ιατρικοί όροι (MeSH): Stroke*/diagnosis , Emergency Medical Services*/methods , Video Recording* , Emergency Medical Service Communication Systems*, Humans ; Denmark ; Female ; Retrospective Studies ; Male ; Aged ; Middle Aged
Περίληψη: Background: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.
Methods: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.
Results: A successful live video transmission was achieved in 550 potential stroke cases, where 52% were correctly examined for facial paresis and 16% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.
Conclusion: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: Video recordings and audio files are stored pseudo-anonymized on secure servers within Copenhagen EMS with restricted access and are retained for a maximum of 5 years, in accordance with the principle of storage limitation. Access to the data is limited to authorized healthcare professionals bound by professional confidentiality. Callers are informed of live video streaming prior to receiving a text message link and must accept terms before the streaming begins. Furthermore, the callers are advised to announce to bystanders that a video streaming to EMCC or OOHS is in process for medical purposes. No individual patient cases are described or exemplified in the manuscript. All data were anonymized prior to statistical analysis. The project was approved by the Danish Data Protection Agency (P-2022–372) and registered as a quality improvement study. Competing interests: The authors declare no competing interests.
References: Clin Epidemiol. 2016 Oct 25;8:697-702. (PMID: 27843349)
BMC Health Serv Res. 2015 Oct 13;15:466. (PMID: 26464109)
Scand J Trauma Resusc Emerg Med. 2019 Jan 9;27(1):3. (PMID: 30626404)
Lancet. 2014 Nov 29;384(9958):1929-35. (PMID: 25106063)
Cochrane Database Syst Rev. 2014 Jul 29;(7):CD000213. (PMID: 25072528)
Eur Stroke J. 2023 Sep;8(3):618-628. (PMID: 37431768)
BMJ Open. 2023 Oct 29;13(10):e077395. (PMID: 37899141)
Emerg Med J. 2021 May;38(5):387-393. (PMID: 33608393)
Scand J Trauma Resusc Emerg Med. 2025 Jan 8;33(1):5. (PMID: 39780267)
J Am Heart Assoc. 2014 Jul 16;3(4):. (PMID: 25030354)
N Engl J Med. 2008 Sep 25;359(13):1317-29. (PMID: 18815396)
Clin Epidemiol. 2020 Nov 16;12:1269-1279. (PMID: 33235507)
JAMA Netw Open. 2025 Jul 1;8(7):e2519020. (PMID: 40591356)
BMJ Open Qual. 2025 Jan 2;14(1):. (PMID: 39753243)
Scand J Trauma Resusc Emerg Med. 2022 Oct 11;30(1):52. (PMID: 36221109)
Neurol Clin Pract. 2023 Dec;13(6):e200197. (PMID: 37854175)
Scand J Trauma Resusc Emerg Med. 2013 Jul 09;21:53. (PMID: 23835246)
Int J Nurs Stud. 2019 Jun;94:186-187. (PMID: 30054007)
Scand J Trauma Resusc Emerg Med. 2016 Jul 07;24:89. (PMID: 27388490)
Lancet. 2024 May 18;403(10440):2133-2161. (PMID: 38642570)
Int J Stroke. 2020 Jul;15(5):555-564. (PMID: 32223543)
BMC Emerg Med. 2025 Sep 26;25(1):191. (PMID: 41013226)
Neurology. 1997 Apr;48(4):891-5. (PMID: 9109873)
BMC Emerg Med. 2021 Sep 6;21(1):101. (PMID: 34488626)
BMC Med Inform Decis Mak. 2024 May 29;24(1):146. (PMID: 38811986)
BMC Emerg Med. 2024 Jun 11;24(1):99. (PMID: 38862922)
Lancet Neurol. 2019 May;18(5):439-458. (PMID: 30871944)
Ann Emerg Med. 2025 Nov;86(5):533-540. (PMID: 40448981)
Resuscitation. 2016 Dec;109:1-8. (PMID: 27658652)
Scand J Trauma Resusc Emerg Med. 2014 Nov 13;22:65. (PMID: 25391354)
Contributed Indexing: Keywords: Emergency medical services; Live video; Medical dispatcher; Neurological exam; Stroke
Entry Date(s): Date Created: 20260203 Date Completed: 20260706 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC12977583
DOI: 10.1186/s13049-026-01559-8
PMID: 41629980
Βάση Δεδομένων: MEDLINE
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  Data: LiVE-STROKE: live video from bystander to the medical dispatcher in potential stroke cases.
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  Data: <searchLink fieldCode="AU" term="%22Rischel+E%22">Rischel E</searchLink>; Copenhagen Emergency Medical Services, Telegrafvej 5, opg. 2, 3rd Floor, Ballerup, Denmark. elise.egebjerg.rischel.01@regionh.dk.<br /><searchLink fieldCode="AU" term="%22Iversen+HK%22">Iversen HK</searchLink>; Department of Neurology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Christensen+H%22">Christensen H</searchLink>; Department of Neurology, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Wenstrup+J%22">Wenstrup J</searchLink>; Prehospital Centre, Region Zealand, Næstved, Denmark.; Department of Brain and Spinal Cord Injuries, Rigshospitalet Glostrup, University Hospital of Copenhagen, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Christensen+HC%22">Christensen HC</searchLink>; Prehospital Centre, Region Zealand, Næstved, Denmark.<br /><searchLink fieldCode="AU" term="%22Linderoth+G%22">Linderoth G</searchLink>; Copenhagen Emergency Medical Services, Telegrafvej 5, opg. 2, 3rd Floor, Ballerup, Denmark.; Department of Anaesthesia and Intensive Care, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
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  Data: <searchLink fieldCode="MM" term="%22Stroke%22">Stroke*</searchLink>/<searchLink fieldCode="MM" term="%22Stroke+diagnosis%22">diagnosis</searchLink> <br /><searchLink fieldCode="MM" term="%22Emergency+Medical+Services%22">Emergency Medical Services*</searchLink>/<searchLink fieldCode="MM" term="%22Emergency+Medical+Services+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Video+Recording%22">Video Recording*</searchLink> <br /><searchLink fieldCode="MM" term="%22Emergency+Medical+Service+Communication+Systems%22">Emergency Medical Service Communication Systems*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Denmark%22">Denmark</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.<br />Methods: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.<br />Results: A successful live video transmission was achieved in 550 potential stroke cases, where 52% were correctly examined for facial paresis and 16% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.<br />Conclusion: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.<br /> (© 2026. The Author(s).)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Ethics approval and consent to participate: Video recordings and audio files are stored pseudo-anonymized on secure servers within Copenhagen EMS with restricted access and are retained for a maximum of 5 years, in accordance with the principle of storage limitation. Access to the data is limited to authorized healthcare professionals bound by professional confidentiality. Callers are informed of live video streaming prior to receiving a text message link and must accept terms before the streaming begins. Furthermore, the callers are advised to announce to bystanders that a video streaming to EMCC or OOHS is in process for medical purposes. No individual patient cases are described or exemplified in the manuscript. All data were anonymized prior to statistical analysis. The project was approved by the Danish Data Protection Agency (P-2022–372) and registered as a quality improvement study. Competing interests: The authors declare no competing interests.
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Clin Epidemiol. 2016 Oct 25;8:697-702. (PMID: <searchLink fieldCode="PM" term="%2227843349%22">27843349)</searchLink><br />BMC Health Serv Res. 2015 Oct 13;15:466. (PMID: <searchLink fieldCode="PM" term="%2226464109%22">26464109)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2019 Jan 9;27(1):3. (PMID: <searchLink fieldCode="PM" term="%2230626404%22">30626404)</searchLink><br />Lancet. 2014 Nov 29;384(9958):1929-35. (PMID: <searchLink fieldCode="PM" term="%2225106063%22">25106063)</searchLink><br />Cochrane Database Syst Rev. 2014 Jul 29;(7):CD000213. (PMID: <searchLink fieldCode="PM" term="%2225072528%22">25072528)</searchLink><br />Eur Stroke J. 2023 Sep;8(3):618-628. (PMID: <searchLink fieldCode="PM" term="%2237431768%22">37431768)</searchLink><br />BMJ Open. 2023 Oct 29;13(10):e077395. (PMID: <searchLink fieldCode="PM" term="%2237899141%22">37899141)</searchLink><br />Emerg Med J. 2021 May;38(5):387-393. (PMID: <searchLink fieldCode="PM" term="%2233608393%22">33608393)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2025 Jan 8;33(1):5. (PMID: <searchLink fieldCode="PM" term="%2239780267%22">39780267)</searchLink><br />J Am Heart Assoc. 2014 Jul 16;3(4):. (PMID: <searchLink fieldCode="PM" term="%2225030354%22">25030354)</searchLink><br />N Engl J Med. 2008 Sep 25;359(13):1317-29. (PMID: <searchLink fieldCode="PM" term="%2218815396%22">18815396)</searchLink><br />Clin Epidemiol. 2020 Nov 16;12:1269-1279. (PMID: <searchLink fieldCode="PM" term="%2233235507%22">33235507)</searchLink><br />JAMA Netw Open. 2025 Jul 1;8(7):e2519020. (PMID: <searchLink fieldCode="PM" term="%2240591356%22">40591356)</searchLink><br />BMJ Open Qual. 2025 Jan 2;14(1):. (PMID: <searchLink fieldCode="PM" term="%2239753243%22">39753243)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2022 Oct 11;30(1):52. (PMID: <searchLink fieldCode="PM" term="%2236221109%22">36221109)</searchLink><br />Neurol Clin Pract. 2023 Dec;13(6):e200197. (PMID: <searchLink fieldCode="PM" term="%2237854175%22">37854175)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2013 Jul 09;21:53. (PMID: <searchLink fieldCode="PM" term="%2223835246%22">23835246)</searchLink><br />Int J Nurs Stud. 2019 Jun;94:186-187. (PMID: <searchLink fieldCode="PM" term="%2230054007%22">30054007)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2016 Jul 07;24:89. (PMID: <searchLink fieldCode="PM" term="%2227388490%22">27388490)</searchLink><br />Lancet. 2024 May 18;403(10440):2133-2161. (PMID: <searchLink fieldCode="PM" term="%2238642570%22">38642570)</searchLink><br />Int J Stroke. 2020 Jul;15(5):555-564. (PMID: <searchLink fieldCode="PM" term="%2232223543%22">32223543)</searchLink><br />BMC Emerg Med. 2025 Sep 26;25(1):191. (PMID: <searchLink fieldCode="PM" term="%2241013226%22">41013226)</searchLink><br />Neurology. 1997 Apr;48(4):891-5. (PMID: <searchLink fieldCode="PM" term="%229109873%22">9109873)</searchLink><br />BMC Emerg Med. 2021 Sep 6;21(1):101. (PMID: <searchLink fieldCode="PM" term="%2234488626%22">34488626)</searchLink><br />BMC Med Inform Decis Mak. 2024 May 29;24(1):146. (PMID: <searchLink fieldCode="PM" term="%2238811986%22">38811986)</searchLink><br />BMC Emerg Med. 2024 Jun 11;24(1):99. (PMID: <searchLink fieldCode="PM" term="%2238862922%22">38862922)</searchLink><br />Lancet Neurol. 2019 May;18(5):439-458. (PMID: <searchLink fieldCode="PM" term="%2230871944%22">30871944)</searchLink><br />Ann Emerg Med. 2025 Nov;86(5):533-540. (PMID: <searchLink fieldCode="PM" term="%2240448981%22">40448981)</searchLink><br />Resuscitation. 2016 Dec;109:1-8. (PMID: <searchLink fieldCode="PM" term="%2227658652%22">27658652)</searchLink><br />Scand J Trauma Resusc Emerg Med. 2014 Nov 13;22:65. (PMID: <searchLink fieldCode="PM" term="%2225391354%22">25391354)</searchLink>
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