Letter by Price et al Regarding Article, “Does Use of the Recognition of Stroke In the Emergency Room Stroke Assessment Tool Enhance Stroke Recognition by Ambulance Clinicians?”

We welcome the comments made by Price et al1 and Brandler and Sharma2 and are grateful for the opportunity to respond to their observations.In our study,3 ambulance clinicians had to suspect a stroke before they used the Recognition of Stroke in the Emergency Room (ROSIER). Our clinicians use a range of factors to suspect that a patient is having a stroke including clinical assessments and observations taken on scene, medical history, history of the current event, medications, and the call determinant allocated during triage of the emergency call for help. Our clinicians practice in line with the Joint Royal Colleges Ambulance Liaison Committee’s UK Ambulance Service Clinical Practice Guidelines.4The average age of patients in our study was indeed relatively young at 65 years; however, this is representative of suspected stroke patients in the area of London where our study was conducted. Our stroke audit figures from last year (2012/13) show that the average age of suspected stroke patients conveyed by our clinicians to the hospital involved in our study was 67 years, which is consistent with the age reported in our article. Information from the 2011 National Census5 confirms that the …