Utstein recommendation for emergency stroke care

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p> Recent advances in treatment for stroke give new possibilities for optimizing outcomes. To deliver these prehospital care needs to become more efficient. </jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p> To develop a framework to support improved delivery of prehospital care. The recommendations are aimed at clinicians involved in prehospital and emergency health systems who will often not be stroke specialists but need clear guidance as to how to develop and deliver safe and effective care for acute stroke patients. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Building on the successful implementation program from the Global Resuscitation Alliance and the Resuscitation Academy, the Utstein methodology was used to define a generic chain of survival for Emergency Stroke Care by assembling international expertise in Stroke and Emergency Medical Services (EMS). Ten programs were identified for Acute Stroke Care to improve survival and outcomes, with recommendations for implementation of best practice. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Efficient prehospital systems for acute stroke will be improved through public awareness, optimized prehospital triage and timely diagnostics, and quick and equitable access to acute treatments. Documentation, use of metrics and transparency will help to build a culture of excellence and accountability. </jats:p></jats:sec>

Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives

“…It has implemented a stroke registry, public awareness and educational programs, promoted techniques for early stroke recognition by first responders, sought to optimize prehospital and in-hospital stroke care, advocated the use of advanced neuroimaging techniques and promoted a culture of excellence. The Utstein community has developed comprehensive plans to improve early diagnosis and treatment of stroke patients globally [ 173 ].…”

Utstein Style for emergency care — the first 30 years

“…This systematic method has more recently been adapted for stroke care 57 .…”

“…In the last few years more fields of medical science have adapted and adopted some of the key principles of the Utstein methodology that are now well established in resuscitation, disaster and pre-hospital medicine. The most recent meetings have focused on maternal and perinatal medicine 55,56 and stroke, 57 and the output of a 2019 meeting on patient safety during surgery, obstetrics and anaesthesia is awaiting publication.…”

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

“…To achieve the best results and reduce the morbidity and mortality of stroke patients, the management of stroke patients must be improved in all steps [11]. Utstein's methodology for process improvement recommends the following strategies: 1. establish a stroke registry, 2. create public awareness, 3. start public education, 4. improve early recognition by first responders, 5. practice rapid and timely dispatch, 6. optimize prehospital stroke care and triage, 7. optimize in-hospital triage and acute care, 8. use smart technologies, 9. demonstrate accountability, and 10. create a culture of excellence [12]. Increasingly often, the implementation of modern technology makes patients more amenable to endovascular treatment.…”