Recommendations for the establishment of primary stroke centers

The Brain Attack Coalition's recommendations for a primary stroke center address the following 11 major aspects of acute stroke care:

  • Acute Stroke Teams -- The Acute Stroke Team should include a physician with experience in diagnosing and treating cerebrovascular disease, and one other healthcare provider as a minimum. Hospital-based stroke teams should be available around-the-clock, seven days a week in order to evaluate within 15 minutes any patient who may have suffered a stroke.

  • Written Care Protocols -- Hospitals should have written procedures to streamline and accelerate the diagnosis and treatment of stroke patients. The availability of such protocols is a key step in reducing time to treatment as well as complications from treatment.

  • Emergency Medical Services -- Emergency medical services (EMS) have a vital role in the rapid transportation and survival of stroke patients. Improved coordination between hospitals and EMS is a cornerstone of a Primary Stroke Center. One element of a well integrated system would be effective communication between EMS personnel and the stroke center during rapid transport of a patient experiencing a stroke.

  • Emergency Department -- The emergency department staff should have training in diagnosing and treating stroke and have good lines of communication with both EMS and the acute stroke team.

  • Stroke Unit -- A Primary Stroke Center wishing to provide care beyond the initial life-threatening period should have access to a Stroke Unit where patients can receive specialized monitoring and care. Some hospitals may choose to stabilize patients and transfer them to another facility.

  • Neurosurgical Services -- Primary Stroke Centers should be able to provide neurosurgical services to stroke patients within two hours of when the services are deemed necessary.

  • Support of Medical Organization -- The facility and its staff, including administration, should be committed to

Contact: Margo Warren or Marian Emr
NIH/National Institute of Neurological Disorders and Stroke

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