The American Heart Association and the American Stroke Association have developed a new process that aims to cut the amount of time between a stroke and initial emergency care to maximize a patient's chance for recovery.
The process uses an algorithm that equips ambulance crews with information and tools to better asses a patient’s condition and determine the best hospital, according to a release from the American Heart Association.
“The new algorithm is needed as new innovations in stroke treatment emerge, such as catheters used to remove large clots in the brain," Dr. Peter D. Panagos, co-chair of the American Heart Association/American Stroke Association Mission Lifeline: Stroke committee that helped oversee and develop the algorithm, said in the release. "Although the intravenous use of tissue plasminogen activator, or IV r-tPA (alteplase), is still the most common standard for treating many strokes, these newer endovascular treatments are appropriate in certain cases. However, they require specific equipment and specially trained personnel that aren’t available at all hospitals, especially those in rural or suburban areas."
The algorithm would place more responisbility on EMS personnel by requiring them to provide quick triage for patients who are most impaired by their stroke through a stroke severity tool, according to the release. The plan should enable EMS to move patients to the nearest hospital with the appropriate treatment options for the given scenario.
“Sometimes, this could mean bypassing a smaller, closer hospital to get the patient to a larger center providing specialized treatment,” Panagos said. “Not only does it help to get stroke patients to the optimal hospital, but the algorithm also requires that smaller centers and larger centers work together in a collaborative fashion to streamline the effective care of stroke patients. We like to consider most care is appropriate locally and reserve transport to larger centers in only the most extreme cases.”
New algorithm could help EMS determine best hospital for treatment of stroke