Prehospital Response and Emergency Stroke Transport Optimisation

This study aims to develop and evaluate an innovative prehospital emergency transport system for patients with acute ischemic stroke to reduce delays in reperfusion treatment. The system integrates artificial intelligence-based prehospital stroke assessment, selected examinations and blood collection in the ambulance, and real-time information sharing between emergency medical services and the receiving hospital. Its effectiveness will be evaluated in a multicenter, stepped-wedge cluster randomized controlled trial comparing the innovative system with standard prehospital care. The primary outcome is the time from hospital arrival to intravenous thrombolysis.

Inclusion Criteria: Hospitals： 1. Hospitals with thrombolysis qualification and equipped with ambulances and pre-hospital emergency personnel. 2. Pre-hospital emergency care can apply the AI-based innovative pre-hospital transport system. 3. The hospital receives at least 60 stroke patients transferred via pre-hospital emergency and receiving intravenous thrombolysis annually. Patients： 1. Age ≥ 18 years. 2. Suspected acute ischemic stroke patients. 3. Symptom onset ≤ 4.5 hours. 4. Arrival at the hospital via the pre-hospital emergency transport system. 5. Signed informed consent. Exclusion Criteria: Hospitals： 1\. Hospitals participating in other research projects aimed at improving pre-hospital emergency processes or stroke thrombolysis treatment. Patients： 1. Patients who arrive at the hospital spontaneously (self-presentation). 2. Patients deemed unsuitable for inclusion in the clinical trial by the investigators.