The whole point should be to get away from primary stroke centers because normal emergency rooms should be able to handle at least the ischemic strokes. All these doctors involved and they don't have a lick of common sense.
http://stroke.ahajournals.org/content/early/2013/11/12/STROKEAHA.113.002285.short
- Mark J. Alberts, MD,
- Lawrence R. Wechsler, MD,
- Mary E. Lee Jensen, MD,
- Richard E. Latchaw, MD,
- Todd J. Crocco, MD,
- Mary G. George, MD,
- James Baranski, BS,
- Robert R. Bass, MD,
- Robert L. Ruff, MD,
- Judy Huang, MD,
- Barbara Mancini, RN,
- Tammy Gregory, BA,
- Daryl Gress, MD,
- Marian Emr, BS,
- Margo Warren, BA and
- Michael D. Walker, MD
+ Author Affiliations
- Correspondence to Mark J. Alberts, MD, Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8897. E-mail Mark.Alberts@UTSouthwestern.edu
Abstract
Background and Purpose—Many
patients with an acute stroke live in areas without ready access to a
Primary or Comprehensive Stroke Center. The formation
of care facilities that meet the needs of
these patients might improve their care and outcomes and guide them and
emergency
responders to such centers within a stroke
system of care.
Methods—The Brain
Attack Coalition conducted an electronic search of the English medical
literature from January 2000 to December
2012 to identify care elements and processes
shown to be beneficial for acute stroke care. We used evidence grading
and consensus
paradigms to synthesize recommendations for
Acute Stroke–Ready Hospitals (ASRHs).
Results—Several key
elements for an ASRH were identified, including acute stroke teams,
written care protocols, involvement of emergency
medical services and emergency department,
and rapid laboratory and neuroimaging testing. Unique aspects include
the use of
telemedicine, hospital transfer protocols,
and drip and ship therapies. Emergent therapies include the use of
intravenous
tissue-type plasminogen activator and the
reversal of coagulopathies. Although many of the care elements are
similar to those
of a Primary Stroke Center, compliance rates
of ≥67% are suggested in recognition of the staffing, logistical, and
financial
challenges faced by rural facilities.
Conclusions—ASRHs
will form the foundation for acute stroke care in many settings.
Recommended elements of an ASRH build on those proven
to improve care and outcomes at Primary
Stroke Centers. The ASRH will be a key component for patient care within
an evolving
stroke system of care.(totally wrong conclusion)
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