RESUMEN
Background: The prognosis of stroke patients can be improved by adherence to clinical guidelines. Objective: To analyse the current state of organisation of prehospital stroke treatment in Germany, Austria and Switzerland with a focus on guideline adherence. Materials and methods: All medical directors of emergency medical services (MDEMS) in Germany (nâ¯= 178), Austria (nâ¯= 9) and Switzerland (nâ¯= 32) were invited to complete an anonymous online survey (unipark.com, Tivian XI GmbH, Cologne, Germany) which was available for 10 weeks from April-June 2020. Participants were asked for information regarding structural organisation, clinical treatment and strategic/tactical aspects. Results: The survey was completed 69 times and 65 datasets were analysed (4 participants without MDEMS status): 73.8% (nâ¯= 48) were MDEMS from Germany, 15.4% (nâ¯= 10) from Switzerland and 10.8% from Austria (nâ¯= 7). The survey results show relevant differences in the infrastructure of and the approach to prehospital stroke treatment. Standard operating procedures for stroke treatment were in place in 93.3% (nâ¯= 61) of the EMS areas. Furthermore, 37% (nâ¯= 24) of the EMS areas differentiated between stroke with mild and severe symptoms and 15.4% (nâ¯= 10) used specific scores for the prehospital prediction of large vessel occlusion strokes (LVOS). Conclusions: Our data highlight the heterogeneity of prehospital stroke treatment in Germany, Austria and Switzerland. Consistent use of appropriate scores for LVOS prediction and a higher adherence to recent clinical guideline in general are measures that should be taken to optimise the prehospital treatment of stroke patients.