By using the Acute Stroke System of Care, you can greatly improve the outcomes of stroke victims. Greater awareness of strokes can be achieved by teaching the community to recognize it as a “brain attack” rather than a stroke, thus emphasizing how important it is to receive medical care within an hour of the first symptoms. Moving victims to stroke care centers equipped with fibrinolytics is crucial, and EMS systems have been taught to do so.
Stroke Chain of Survival
Figure 17
Goals of Acute Ischemic Stroke Care
Stroke care is concerned with optimizing the patient’s recovery while simultaneously minimizing brain injury from the stroke. By focusing on transporting patients to stroke-capable centers, general results are improved. This is because stroke centers are much better equipped with the facilities and resources that smaller community hospitals may lack. Specialists such as stroke care specialists and neurologists, as well as multidisciplinary teams with advanced imaging modalities and several other therapeutic options, provide the best chances for a stroke victim’s survival and recovery. Within just 10 minutes, these specialized teams can examine and diagnose the patient who is suspected to have had a stroke.
The major steps of stroke diagnosis and treatment, as well as key points at which delays can occur, are highlighted in the 8 D’s of Stroke Care (Table 2).
The 8 D’s of Stroke Care
| Detection | Rapid recognition of stroke symptoms |
| Dispatch | Early activation and dispatch of EMS |
| Delivery | Rapid EMS identification, management, and transport |
| Door | Transport to stroke center |
| Data | Rapid triage, evaluation, and management in ED |
| Decision | Stroke expertise and therapy selection |
| Drug | Fibrinolytic therapy, intra-arterial strategies |
| Disposition | Rapid admission to the stroke unit or critical care unit |
Table 2