• Martin Lier, Maximilian Euler, Markus Roessler, Jan Liman, Meike Bettina Goericke, Michael Baubin, Stefan Matthias Mueller, and Nils Kunze-Szikszay.
• Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Deutschland.
• Notfall Rettungsmed. 2023 Jan 20: 191-9.

BackgroundThe prognosis of stroke patients can be improved by adherence to clinical guidelines.ObjectiveTo analyse the current state of organisation of prehospital stroke treatment in Germany, Austria and Switzerland with a focus on guideline adherence.Materials And MethodsAll medical directors of emergency medical services (MDEMS) in Germany (n = 178), Austria (n = 9) and Switzerland (n = 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.ResultsThe survey was completed 69 times and 65 datasets were analysed (4 participants without MDEMS status): 73.8% (n = 48) were MDEMS from Germany, 15.4% (n = 10) from Switzerland and 10.8% from Austria (n = 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% (n = 61) of the EMS areas. Furthermore, 37% (n = 24) of the EMS areas differentiated between stroke with mild and severe symptoms and 15.4% (n = 10) used specific scores for the prehospital prediction of large vessel occlusion strokes (LVOS).ConclusionsOur 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.© The Author(s) 2023.

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