Background

Early recognition and decision-making are critical in acute stroke care. Prehospital video consultation may support collaboration and inform triage decisions between ambulance nurses (ANs) and neurologists. However, organizational and geographical factors may delay access to reperfusion therapies. This feasibility study explored whether prehospital video consultation between ANs and neurologists could be implemented in routine stroke care and how such consultations might influence workflow and perceptions of patient safety.

Methods

We conducted a mixed-methods feasibility study with parallel collection of quantitative and qualitative data. Quantitative data on processing times and patient flow were extracted from ambulance and hospital records. Qualitative data were obtained from semi-structured interviews and evaluation forms. The intervention was implemented in 12 ambulances across four districts over a 13-month period. Patients with suspected large vessel occlusion (LVO) and a modified NIH Stroke Scale (mNIHSS) score ≥ 6 were eligible.

Results

Forty-four patients met the inclusion criteria; however, only five video consultations were successfully completed, partly due to limited equipment availability. Quantitative findings were therefore presented descriptively. Among the five completed video consultations, two patients were transported directly to the regional stroke center, compared to 24 of 148 patients in the non-video group. The qualitative analysis identified three themes: (1) interprofessional collaboration and trust (2), practical use of video, and (3) barriers and facilitators to implementation.

Conclusions

Prehospital video consultation in suspected stroke was technically feasible in individual cases and perceived as supportive by clinicians. However, technical and organizational barriers substantially limit routine use. The findings provide important insights into professional, organizational, and technical factors influencing feasibility, but do not permit conclusions regarding clinical effectiveness.