“Both my brain stroke and my heart attack were only diagnosed two days later. I did not receive the right treatment in two different hospitals, in two different countries [Luxembourg and the Netherlands]”
(Female stroke survivor)
Healthcare professionals who have not had specific stroke training (ambulance and emergency staff, as well as general hospital staff and primary care physicians) can contribute to delays and therefore the current ESO guidelines recommend educational programmes for professionals. There is some evidence from most European countries that professionals are being educated to some extent with regards to stroke as a medical emergency. However, evidence is mainly anecdotal, relating to individual events, or national stroke guideline recommendations are being used as evidence.
Few studies into the impact of such training programmes exist. A German study found reduced in-hospital delays and increased thrombolysis rate following an educational program for emergency staff. A Finnish trial of a new emergency medical services training programme reported a reduction in the time ambulance crews spend assessing and treating patients before transporting them to hospital after ambulance crew training. Other studies describe a lack of emergency staff training (Italy: low number of emergency staff activating the stroke code, Lithuania: current training inadequate, France: suboptimal professional practices and coordination as a barrier to effective stroke care pathways).
There is no clear picture across Europe about the extent, intensity or impact of training that is available or systematically provided for non-stroke specialist medical staff.