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Review
. 2023 Apr;54(4):1138-1147.
doi: 10.1161/STROKEAHA.122.039586. Epub 2022 Nov 29.

Prehospital Stroke Care Part 1: Emergency Medical Services and the Stroke Systems of Care

Kori S Zachrison  1 , Victoria M Nielsen  2 , Natalia Perez de la Ossa  3 , Tracy E Madsen  4 , Rebecca E Cash  1 , Remle P Crowe  5 , Erika C Odom  6 , Edward C Jauch  7 , Opeolu M Adeoye  8 , Christopher T Richards  9
Affiliations
Review

Prehospital Stroke Care Part 1: Emergency Medical Services and the Stroke Systems of Care

Kori S Zachrison et al. Stroke. 2023 Apr.

Abstract

Acute stroke care begins before hospital arrival, and several prehospital factors are critical in influencing overall patient care and poststroke outcomes. This topical review provides an overview of the state of the science on prehospital components of stroke systems of care and how emergency medical services systems may interact in the system to support acute stroke care. Topics include layperson recognition of stroke, prehospital transport strategies, networked stroke care, systems for data integration and real-time feedback, and inequities that exist within and among systems.

Keywords: delivery of healthcare; emergency medical services; stroke; stroke center.

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Figures

Figure.
Figure.. Stroke chain of survival within a systems of care framework.
EMD indicates emergency medical dispatcher; and EMS, emergency medical services.
See this image and copyright information in PMC

References

    1. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke A. Stroke 2019;50:E344–E418. doi: 10.1161/STR.0000000000000211 - DOI - PubMed
    1. Moser DK, Kimble LP, Alberts MJ, Alonzo A, Croft JB, Dracup K, Evenson KR, Go AS, Hand MM, Kothari RU, et al. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. J Cardiovasc Nur. 2007;22:326–343. doi: 10.1097/01.jcn.0000278963.28619.4a - DOI - PubMed
    1. Higashida R, Alberts MJ, Alexander DN, Crocco TJ, Demaerschalk BM, Derdeyn CP, Goldstein LB, Jauch EC, Mayer SA, Meltzer NM, et al.; American Heart Association Advocacy Coordinating Committee. Interactions within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association. Stroke. 2013;44:2961–2984. doi: 10.1161/STR.0b013e3182a6d2b2 - DOI - PubMed
    1. Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, Khalessi AA, Bushnell C, Barsan WG, Panagos P, et al. Recommendations for the establishment of stroke systems of care: a 2019 update: a policy statement from the American Stroke Association. Stroke 2019;50:e187–e210. doi: 10.1161/STR.0000000000000173 - DOI - PubMed
    1. Patel MD, Rose KM, O’Brien EC, Rosamond WD. Prehospital notification by emergency medical services reduces delays in stroke evaluation: findings from the North Carolina stroke care collaborative. Stroke. 2011;42:2263–2268. doi: 10.1161/STROKEAHA.110.605857 - DOI - PMC - PubMed