Investigating the Need for Prehospital Education to Include Sex Differences in the Clinical Presentation of Stroke

Abstract

Since Congress passed the National Institute of Health Revitalization Act of 1993, a document that mandates the inclusion of women and minority groups into medical research, sex differences in the clinical presentations of diseases and responses to medication have emerged.¹ It has been found that women and men can present differently when experiencing a stroke, with women more often experiencing ‘atypical’ or ‘nontraditional’ signs and symptoms.^2-8 Prehospital curriculum standards have not yet included this information for emergency medical technicians (EMTs) or paramedics. Further, prehospital provider education standards do not require competency in sex differences in epidemiology, physiology, pathophysiology, or pharmacology.^9,10 Patients of EMS providers would likely benefit if their providers were aware of these sex differences, as previous research has found that women experiencing a stroke receive a lower quality of EMS care compared to men.¹¹ Early identification of stroke and timely notification to the nearest appropriate hospital can impact treatment decisions, and time to treatment can heavily influence functional outcomes.¹² Since there is robust evidence that the clinical presentation, quality of care, and health outcomes of stroke differ between men and women, EMS education should include and emphasize these topics.