EMS Management of Acute Stroke—Prehospital Triage (Resource Document to NAEMSP Position Statement)

Crocco, Todd J.; Grotta, James C.; Jauch, Edward C.; Kasner, Scott E.; Kothari, Rashmi; Larmon, Baxter; Saver, Jeffrey L.; Sayre, Michael R.; Davis, Stephen M.

doi:10.1080/10903120701347844

Cited by 42 publications

(38 citation statements)

References 52 publications

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“…51,58 The cooperation between EMS and the PSC should be documented by written protocols for transporting patients with stroke by EMS to the PSC, a letter of cooperation between the PSC and EMS, and evidence of cooperative educational activities at least twice per year. 46,51 The issue of whether EMS personnel should take patients with acute stroke only to facilities with a Stroke Center has been addressed in recent guidelines. It is now a Class I, Level B recommendation that patients with acute strokes be transported initially to the nearest facility that can operate as a PSC.…”

Section: Emergency Medical Servicesmentioning

confidence: 99%

“…42 Patients with stroke who activate the EMS system by calling 911 and are transported by EMS clearly demonstrate shorter delay times and more rapid assessment and treatment. 23,[42][43][44][45][46][47][48][49] Notification of EMS of a call for a patient with a possible stroke should be assigned a high priority to ensure rapid transportation. 43 A significant challenge is that the EMS system is not nationally regulated in the United States, which makes it difficult to design and mandate specific educational programs and care protocols.…”

Section: Emergency Medical Servicesmentioning

confidence: 99%

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Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Alberts

Latchaw

Jagoda

et al. 2011

Stroke

195

167

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for the Brain Attack CoalitionBackground and Purpose-The formation and certification of Primary Stroke Centers has progressed rapidly since the Brain Attack Coalition's original recommendations in 2000. The purpose of this article is to revise and update our recommendations for Primary Stroke Centers to reflect the latest data and experience. Methods-We conducted a literature review using MEDLINE and PubMed from March 2000 to January 2011. The review focused on studies that were relevant for acute stroke diagnosis, treatment, and care. Original references as well as meta-analyses and other care guidelines were also reviewed and included if found to be valid and relevant. Levels of evidence were added to reflect current guideline development practices. Results-Based on the literature review and experience at Primary Stroke Centers, the importance of some elements has been further strengthened, and several new areas have been added. These include (1) the importance of acute stroke teams; (2) the importance of Stroke Units with telemetry monitoring; (3) performance of brain imaging with MRI and diffusion-weighted sequences; (4) assessment of cerebral vasculature with MR angiography or CT angiography; (5) cardiac imaging; (6) early initiation of rehabilitation therapies; and (7) certification by an independent body, including a site visit and disease performance measures. Conclusions-Based on the evidence, several elements of Primary Stroke Centers are particularly important for improving the care of patients with an acute stroke. Additional elements focus on imaging of the brain, the cerebral vasculature, and the heart. These new elements may improve the care and outcomes for patients with stroke cared for at a Primary Stroke Center. (Stroke. 2011;42:2651-2665.)

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Section: Emergency Medical Servicesmentioning

confidence: 99%

Section: Emergency Medical Servicesmentioning

confidence: 99%

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Alberts

Latchaw

Jagoda

et al. 2011

Stroke

195

167

View full text Add to dashboard Cite

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“…Prehosp Emerg Care. [23] procedures section of the document is extensive, describing how every procedure should be carried out. If the North Carolina Medical Board lists a procedure that is within the scope of practice of an EMS provider, then the EMS Procedure section of the document must describe how to perform the procedure.…”

Section: Ems Proceduresmentioning

confidence: 99%

North Carolina College of Emergency Physicians' Guidance Document on Emergency Medical Services

Winslow

Fernández

Swanson

et al. 2015

North Carolina Medical Journal

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The North Carolina College of Emergency Physicians (NCCEP) Emergency Medical Services (EMS) Committee uses an evidence-based approach in writing its protocols and procedures. The most recent revision of the NCCEP document, which was started in late 2010, lasted for more than 1 year and utilized committee members from across the state. Four meetings were held at locations across North Carolina. In addition, 2 surveys were sent to get input from EMS providers. Since 2010, the document has been updated on an ongoing basis, aligning it with the latest evidencebased medicine.

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“…59 To avoid transfer delay, regional protocols for triage of AIS patients by EMS personnel to designated stroke centers has become a focus of prehospital stroke triage policy. 60 Alternative strategies include initiation of IV thrombolytic in a referring hospital prior to transfer "drip-and-ship," followed by further management at the accepting hospital, which may include ERT. A described model of "drip, ship, and retrieve" used full-dose IV rtPA (0.9 mg/kg) followed by ERT with mechanical thrombectomy and thrombo-aspiration, suggesting feasibility in basilar artery occlusion.…”

mentioning

confidence: 99%

Developing practice recommendations for endovascular revascularization for acute ischemic stroke

et al. 2012

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Guidelines have been established for the management of acute ischemic stroke; however, specific recommendations for endovascular revascularization therapy are lacking. Burgeoning investigation of endovascular revascularization therapies for acute ischemic stroke, rapid device development, and a diverse training background of the providers performing the procedures underscore the need for practice recommendations. This review provides a concise summary of the Society of Vascular and Interventional Neurology endovascular acute ischemic stroke roundtable meeting. This document was developed to review current clinical efficacy of pharmacologic and mechanical revascularization therapy, selection criteria, periprocedure management, and endovascular time metrics and to highlight current practice patterns. It therefore provides an outline for the future development of multisociety guidelines and recommendations to improve patient selection, procedural management, and organizational strategies for revascularization therapies in acute ischemic stroke. Neurology

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EMS Management of Acute Stroke—Prehospital Triage (Resource Document to NAEMSP Position Statement)

Cited by 42 publications

References 52 publications

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

Revised and Updated Recommendations for the Establishment of Primary Stroke Centers

North Carolina College of Emergency Physicians' Guidance Document on Emergency Medical Services

Developing practice recommendations for endovascular revascularization for acute ischemic stroke

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