Background: Elderly individuals, due to their specific health conditions, are more susceptible to acute strokes. In mass gatherings, providing prehospital emergency services to this group faces numerous challenges. This study examines the challenges of prehospital emergency services for
elderly patients referred with
acute stroke code in
mass gatherings and identifies potential solutions to improve service delivery in these critical conditions. Materials and Methods: A comprehensive search was conducted based on the Cochrane systematic review principles and PRISMA guidelines to identify studies addressing the challenges and solutions related to prehospital emergency services for
elderly individuals referred with
acute stroke code in mass gatherings. Keywords such as "prehospital emergency," "elderly," "stroke," and "gatherings" were used without temporal restrictions in various databases, including PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Google Scholar was also utilized to explore grey literature. Studies published in both English and Persian were selected for a more comprehensive coverage. Two researchers independently performed the screening and data extraction processes, and discrepancies were resolved through consensus with a third researcher. Inclusion criteria consisted of cross-sectional, cohort, case-control, and interventional studies, and the quality of these studies was assessed using the Critical Appraisal Skills Program (CASP) checklist. Results: In the conducted search, ۷۵ studies were identified that addressed the challenges and solutions of prehospital emergency services for
elderly individuals with
acute stroke in mass gatherings. Among these, ۳۶ were cross-sectional studies, ۲۲ cohort studies, ۸ case-control studies, and ۹ interventional studies. The main challenges included the management of response times and patient transfer, the lack of advanced equipment such as Mobile Stroke Care Units, and deficiencies in coordination among different teams. These issues could be improved through the enhancement of equipment, strengthened coordination, and the use of innovative technologies such as the Mobile Emergency Operations Center (MEOC) and Motorlance. Furthermore, the lack of appropriate infrastructure for Green Lane and the shortage of language interpreters in dispatch centers are other limitations that require special attention. Strengthening clinical education and conducting tabletop exercises could also contribute to improving the efficiency of emergency services and therapeutic outcomes. Conclusion: This study highlights the challenges faced by prehospital emergency services for
elderly stroke patients in mass gatherings, including time management, lack of advanced equipment, and poor coordination. Improving equipment, communication, and utilizing new technologies can address these issues, ultimately enhancing service quality and patient outcomes.
