AHA publishes new recommendations for transporting stroke patients

A paper from the Prehospital Stroke System of Care Consensus Conference offers guiding principles for triage and transport destinations


By Laura French

DALLAS — The American Heart Association has published new recommendations for prehospital triage and transport of stroke patients. 

A consensus statement, developed through the Prehospital Stroke System of Care Consensus Conference and published in the AHA journal Stroke, outlines guiding principles for determining transport destinations in rural, suburban and urban communities.

The statement comes from the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgey and Society of Vascular and Interventional Neurology, and is endorsed by The Neurocritical Care Society. 

"With the advent of new treatments for stroke such as thrombectomy, the American Stroke Association recognizes the need for a national consensus approach to acute stroke prehospital triage that considers differences in regional plans in urban, suburban and rural environments," said American Stroke Association Advisory Committee Chair Lee H. Schwamm, MD, in a statement. "In time-critical conditions, the capabilities of the first destination hospital can strongly influence clinical outcomes, so it is vital to integrate both speed of transport with level of stroke care required for definitive treatment. This new statement, developed through consensus of leading professional organizations focused on stroke, provides needed recommendations to local communities and regions to improve their stroke systems of care." 

The authors stress that patients with suspected stroke due to large vessel occlusion (LVO) should be preferentially triaged to the nearest endovascular therapy (EVT) capable stroke center, and that local public health agencies are best suited to determine the most appropriate stroke destination plans given unique regional and geographic considerations. The paper offers three separate sets of recommendations for stroke systems of care in rural, suburban and urban communities.

The full paper can be accessed online on the AHA Journals website, and further information about prehospital stroke care is provided by the American Stroke Association. A summary of the recommendations can be read below:

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