LiVE-STROKE: Live video from bystander to the medical dispatcher in potential stroke cases

E Rischel; H K Iversen; H Christensen; J Wenstrup; H. C. Christensen; G Linderoth

doi:10.1186/s13049-026-01559-8

LiVE-STROKE: Live video from bystander to the medical dispatcher in potential stroke cases

E Rischel^*
, H K Iversen
, H Christensen
, J Wenstrup
, H. C. Christensen
, G Linderoth

^*Corresponding author for this work

Emergency Response Centre

Research output: Contribution to journal › Article › Research › peer-review

Abstract

BACKGROUND: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.

METHODS: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.

RESULTS: A successful live video transmission was achieved in 550 potential stroke cases, where 52% were correctly examined for facial paresis and 16% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.

CONCLUSION: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.

Original language	English
Article number	55
Journal	Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume	34
Issue number	1
Early online date	3 Feb 2026
DOIs	https://doi.org/10.1186/s13049-026-01559-8
Publication status	Published - 3 Feb 2026

Keywords

Aged
Aged, 80 and over
Denmark
Emergency Medical Dispatcher
Emergency Medical Service Communication Systems
Emergency Medical Services/methods
Female
Humans
Male
Middle Aged
Retrospective Studies
Smartphone
Stroke/diagnosis
Video Recording
Neurological exam
Stroke
Live video
Medical dispatcher
Emergency medical services

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10.1186/s13049-026-01559-8

Cite this

@article{82b3d748adfc4b83a3aa254757010921,

title = "LiVE-STROKE: Live video from bystander to the medical dispatcher in potential stroke cases",

abstract = "BACKGROUND: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.METHODS: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.RESULTS: A successful live video transmission was achieved in 550 potential stroke cases, where 52\% were correctly examined for facial paresis and 16\% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16\% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46\% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.CONCLUSION: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.",

keywords = "Aged, Aged, 80 and over, Denmark, Emergency Medical Dispatcher, Emergency Medical Service Communication Systems, Emergency Medical Services/methods, Female, Humans, Male, Middle Aged, Retrospective Studies, Smartphone, Stroke/diagnosis, Video Recording, Neurological exam, Stroke, Live video, Medical dispatcher, Emergency medical services",

author = "E Rischel and Iversen, \{H K\} and H Christensen and J Wenstrup and Christensen, \{H. C.\} and G Linderoth",

note = "{\textcopyright} 2026. The Author(s).",

year = "2026",

month = feb,

day = "3",

doi = "10.1186/s13049-026-01559-8",

language = "English",

volume = "34",

journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",

issn = "1757-7241",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - LiVE-STROKE

T2 - Live video from bystander to the medical dispatcher in potential stroke cases

AU - Rischel, E

AU - Iversen, H K

AU - Christensen, H

AU - Wenstrup, J

AU - Christensen, H. C.

AU - Linderoth, G

PY - 2026/2/3

Y1 - 2026/2/3

N2 - BACKGROUND: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.METHODS: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.RESULTS: A successful live video transmission was achieved in 550 potential stroke cases, where 52% were correctly examined for facial paresis and 16% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.CONCLUSION: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.

AB - BACKGROUND: Identification of stroke during an emergency call remains challenging. We aimed to explore performed stroke examination with prehospital live video transmission during an emergency call from a bystander's smartphone to the medical dispatcher.METHODS: Since 2019, the Emergency Medical Services (EMS) in Copenhagen, consisting of the Emergency Medical Coordination Centre (EMCC) and the Out-of-Hours Health Service (OOHS), have enabled medical dispatchers to add live video to emergency calls. Dispatchers are registered nurses or paramedics. Live video is initiated via text message link sent to the caller's smartphone. We included all cases where the dispatcher added live video to the emergency call and stroke was suspected or later identified according to the Danish Stroke Registry. The video-recorded on-site stroke examinations were retrospectively analyzed. No specific guidance for video-based stroke examination was in place.RESULTS: A successful live video transmission was achieved in 550 potential stroke cases, where 52% were correctly examined for facial paresis and 16% for both facial and extremities paresis. In six patients, hemiparesis was observed without an examination. The group with 'considered stroke' had the highest amount of examined cases. Dispatchers suspected stroke in 450 cases, and stroke was confirmed in 16% (n = 73). Stroke was diagnosed in 126 cases and was not suspected in 46% of these cases (missed stroke n = 63, TIA n = 10). Patients with missed stroke had significantly less accurate examinations and more often hemorrhagic stroke, compared to patients with confirmed stroke.CONCLUSION: Video is not routinely used for stroke assessment during emergency calls, and only a small number of cases are sufficiently examined for stroke with video. Implementation of a structured protocol for live video guided stroke examinations during emergency calls could be beneficial but best practice is still unknown.

KW - Aged

KW - Aged, 80 and over

KW - Denmark

KW - Emergency Medical Dispatcher

KW - Emergency Medical Service Communication Systems

KW - Emergency Medical Services/methods

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Smartphone

KW - Stroke/diagnosis

KW - Video Recording

KW - Neurological exam

KW - Stroke

KW - Live video

KW - Medical dispatcher

KW - Emergency medical services

U2 - 10.1186/s13049-026-01559-8

DO - 10.1186/s13049-026-01559-8

M3 - Article

C2 - 41629980

SN - 1757-7241

VL - 34

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

IS - 1

M1 - 55

ER -

LiVE-STROKE: Live video from bystander to the medical dispatcher in potential stroke cases

Abstract

Keywords

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