Table 2 Patient-reported Facilitators and Barriers for EMS Vehicle Use (selections out of an itemized list; multiple reasons per patient, total adds to more than 108)

 A neighbor or family member agreed/insisted to call 911

 Symptoms were severe and scary

 I felt my symptoms could be stroke

 I knew that arriving at the hospital quickly was important

 I felt ambulance was the best way to get care

 My doctor/nurse told me to call 911 if I had symptoms

 I was unconscious; a bystander called 911

 I know someone with bad effects of stroke due to not calling ambulance

 I normally take care of my health and felt I needed care urgently

 I knew others who became disabled or died from stroke

 I/We had good prior experience with using ambulance

 Symptoms took a long time to become serious

 I live out in the country, driving may be quicker than ambulance

 I felt normal; symptoms came and went

 I had no pain, so I did not feel it was urgent or serious

 I called my doctor and they asked me to go directly to the hospital ER

 Family member present insisted we should not call ambulance

 I was at work/somewhere else and waited till I could leave

 I did not know that I could have serious problems if not treated quickly

 I have no insurance, will get a big bill/worried about my share of ambulance cost/insurance may not cover if symptom is not serious

 I/my family member had a large medical expense or bills before this

 There is a long waiting time at the ER anyway, so might as well go by car

 The ambulance siren and lights will disturb neighbors, and I don’t want them to know my business

 My family members were out

 I live alone and was too weak to call