Management of possible stroke by laypeople in pre-hospital setting: who should we train?

Management of possible stroke by laypeople in pre-hospital setting: who should we train?


  • Giuseppe Stirparo Faculty of Medicine, School of Public Health – Università Vita-Salute San Raffaele, 20132 Milan, Italy
  • Erika Kacerik Faculty of Medicine, School of Public Health – Università Vita-Salute San Raffaele, 20132 Milan, Italy
  • Giuseppe Ristagno Department of Fisiopatologia Medico-Chirurgica e dei Trapianti – Università degli Studi di Milano, 20122 Milan
  • Aida Andreassi Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Anna Coppo Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Maurizio Migliari Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Andrea Albonico Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Giuseppe Maria Sechi Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Alberto Zoli Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)
  • Carlo Signorelli Faculty of Medicine, School of Public Health – Università Vita-Salute San Raffaele, 20132 Milan, Italy


emergency care pre-hospital, emergency medical services, Italy, stroke, training


Background and aim: The pre-hospital management of a possible stroke is fundamental for the transport of patients to the correct HUB facility; thus, they must be transported to the Emergency Department (ED) by EMS vehicles. Our study aims to analyze the factors correlated with a higher probability of accessing the ED through the EMS in this event.

Methods: This is a retrospective observational study. All accesses in the 120 EDs of the Lombardy region, with a diagnosis of discharge whose symptoms could resemble CPSS, were analyzed between 1 January 2019 and 31 December 2019.

Results: We identified an increased probability of using the EMS vehicles of 0,05% (I.C. 95%: 0.04% - 0.06%; p<0.0001) for each additional year of age, considering patients aged 20 to 100 years and the percentage was significantly higher in the female population (58% vs 49%; p<0.001). Moreover, we calculated that the incidence of stroke was approximately 140 cases per 100,000 inhabitants.

Conclusions: Only half of the citizens in the Lombardy region use the EMS in case of suspicion of stroke; further information campaigns are essential to educate citizens. Information strategies should be directed especially at men between 30 and 59 years old.

Author Biographies

Giuseppe Stirparo, Faculty of Medicine, School of Public Health – Università Vita-Salute San Raffaele, 20132 Milan, Italy

Second affiliation:

Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ)

Giuseppe Ristagno , Department of Fisiopatologia Medico-Chirurgica e dei Trapianti – Università degli Studi di Milano, 20122 Milan

Second affiliation:

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20090 Milan, Italy


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How to Cite

Management of possible stroke by laypeople in pre-hospital setting: who should we train?. Acta Biomed [Internet]. 2023 Oct. 17 [cited 2024 Jun. 24];94(5):e2023203. Available from: