The effectiveness of using a checklist in prehospital stroke interventions in the Republic of Moldova

Abstract

Introduction. Stroke remains a major cause of mortality and disability in Moldova and globally. Rapid prehospital intervention is critical for improving outcomes. The adoption of standardized protocols and checklists has enhanced the efficiency of emergency medical services (EMS), especially in stroke recognition and initial management. Materials and methods. A systematic review of the literature and analysis of statistical data from the National Prehospital Emergency Medical Service were conducted. The study focused on evaluating the use and impact of checklists during prehospital stroke interventions. Results. Between 2022 and 2023, over 12,000 stroke cases were recorded annually. The implementation of national checklists, in conjunction with the Face, Arm, Speech, Time scale, significantly improved early identification, triage, and transport to specialized centers. Notable outcomes included a higher rate of thrombolysis and thrombectomy, improved coordination, and a modest reduction in overall response time. However, delays due to inter-hospital transfers remain a challenge. Conclusions. The systematic use of checklists in prehospital stroke management in Moldova proved effective in standardizing care, accelerating intervention, and improving patient outcomes. Continued training and system reorganization are crucial to fully capitalize on these tools and to reduce stroke-related morbidity and mortality.