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Acute Stroke Systems Of Care

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Outcomes for individuals with stroke have improved significantly due to the implementation of Acute Stroke System of Care. The community is better equipped to recognize stroke as a “brain attack,” and there is greater awareness of the importance of medical care within three hours of symptom onset because you will have the opportunity to reverse said symptoms with the fibrinolytic. Likewise, EMS systems have been enhanced to transport individuals to regional stroke care centers that are equipped to administer fibrinolytics.

Stroke Chain of Survival

ACLS Stroke Chain of Survival

Figure 17

FAST Acronym

The FAST acronym is based on the Cincinnati Pre-Hospital Stroke Scale and is used to evaluate when someone is having a stroke.

Face Grimace or drooping on one side
Arms Weakness drift or paralysis on the same side
Speech Slurred or incomprehensible
Time Time of activity and time to call 911

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.

Take Note

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 within three hours of symptom onset
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

Advanced Cardiac Life Support (ACLS) Certification Course

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