Video Consultation in Prehospital Stroke Care: Results From a Pilot Feasibility Study

Journal article, 2026

Introduction: Timely prehospital stroke assessment and accurate triage are essential for improving patient outcomes, especially for those eligible for thrombectomy due to large vessel occlusion (LVO). This pilot study explores the feasibility of video consultations between ambulance nurses (ANs) and stroke neurologists to enhance decision-making in the prehospital stroke care pathway. Methods: A prospective observational cohort study was conducted over 12 months. Patients with suspected stroke were assigned to either video-assisted ambulances (n = 19) or standard ambulances (n = 44). The primary outcome was direct transport to the comprehensive stroke center (CSC). Secondary outcomes included prehospital time intervals and time to stroke treatment. Statistical analyses were performed using Mann–Whitney U and Fisher’s exact tests, with p < 0.05 considered significant. Results: Patients in the video group had significantly longer transport times to the hospital (median 31 min vs. 17 min, p < 0.05), reflecting geographic differences. However, total prehospital time and time to treatment did not differ significantly. A higher proportion of video group patients were transported directly to the CSC (9/19 [47%] vs. 13/44 [30%], p = 0.25). No patients in the video group required secondary transport, whereas 5/44 (11%) in the nonvideo group did. Thrombectomy rates were similar between groups (4/19 [21%] vs. 10/44 [23%], p = 1.00). However, among patients who underwent thrombectomy, a higher proportion in the video group were transported directly to the CSC, without requiring secondary transfer. Conclusion: Video consultations between ANs and neurologists may be feasible in terms of clinical workflow. The primary outcome, direct transport to the CSC, was higher in the video group, indicating potentially improved triage accuracy, and importantly, the intervention did not prolong on-scene time. Video support may reduce delays associated with secondary transport. Although the sample size limits statistical power, these initial findings warrant further investigation through larger studies to evaluate the impact of video support on clinical outcomes.