http://stroke.ahajournals.org/content/48/11/e323?etoc=
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Stroke
care is team-based care, but trainees in neurology programs may have
little experience in working directly with stroke specialists from other
disciplines. Outside of an intensive care unit, nurses and physicians
rarely round as a team, and stroke neurologists often have few
interactions with prehospital care providers besides a quick handoff in
the emergency room. However, nonphysician stroke specialists bring a
broad base of expertise which overlaps with and complements the stroke
neurologist’s knowledge. Increasingly, integrated stroke care is being
provided by multidisciplinary teams. Team structures may vary from
hospital to hospital and country to country, but often include
integration of emergency medical services (EMS; particularly where
mobile stroke treatment units are used); specialized nurses and nurse
practitioners (NPs); and specialized therapy teams including speech and
language pathologists, occupational therapists, and physical therapists
with particular expertise in poststroke care.
Prehospital Care
The
stroke chain of survival begins with the 911 call, yet even high-level
paramedics receive little formal stroke training outside of standard
Advanced Cardiac Life Support protocols. EMS providers are often the
first point of contact for the stroke patient and have the opportunity
to collect vital information about timing of symptoms and medication
use. First responders to stroke 911 calls may be Basic Life Support or
Advanced Cardiac Life Support level. EMS providers should be familiar
with validated prehospital stroke scales such as the Cincinnati
Prehospital Stroke Scale.1
EMS
providers who have more experience with stroke, such as paramedics who
staff mobile stroke treatment units, find stroke to be an exciting field
because of the time-critical nature of the treatment. Therefore, it is
imperative that stroke neurologists reach out to EMS providers to offer
additional training in stroke care. A basic understanding of stroke
syndromes is both fascinating and extremely useful to EMS providers, who
are often eager …
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