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Abstract
Objective. To improve stroke knowledge, identification, and acute care among first responders (FRs) and emergency medical technicians (EMTs) through educational outreach and support. Methods. Beginning in 2006, the Montana Stroke Initiative implemented outreach to FRs and EMTs and emergency medical services (EMS) statewide. Cross-sectional telephone surveys of FRs and EMTs were used to evaluate changes in stroke knowledge and practice in 2006 (n == 988) and 2009 (n == 944), overall and in rural and urban counties. Results. The respondents to the 2009 survey were more likely to report the availability of a stroke protocol in their service (69%% vs. 61%%, p == 0.001), training in the use of a stroke screening tool (62%% vs. 42%%, p < 0.001), use of a stroke screening tool (62%% vs. 40%%, p < 0.001), and an adequate level of knowledge about stroke (81%% vs. 66%%, p < 0.001) compared with the respondents to the 2006 survey. Significant improvements in each of these areas were achieved for both rural and urban FRs and EMTs. Conclusions. Educational outreach to FRs and EMTs was associated with marked improvement in selected components of the EMS system of stroke care.