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Home > Topics > Cardiac Care
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EMS News in Focus
by Arthur Hsieh

Send your patient to the right facility

By Arthur Hsieh

Editor's note: A Calif. county is linking hospitals that have stroke treatment expertise with responders to help prevent delay of treatment. Editorial Advisor Art Hsieh says it's crucial your patient matches the criteria for transport to the appropriate facility.

More systems are implementing systems of care that will help send patients with time dependent illnesses to the appropriate facilities. It's a reminder of how we serve as a gateway function to the healthcare system. It's crucial that we remember to look for the critical signs and symptoms of an acute stroke:

  • Sudden onset of weakness, tingling or other paresthesia, especially if it's located to one side or another
  • Slurring of speech, or confused speech
  • Acute onset of confusion, altered mental status or unconsciousness
  • Headache, especially if described as the "worst" one ever
  • Changes in vital signs, including hypertension or bradycardia

Many of these signs can be attributed to other conditions — check oxygenation, blood glucose levels, and a stroke assessment to refine your impression.

Make sure your patient matches the criteria for transport to the appropriate facility. Time will count and you may make the difference!

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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