Ohio bill would require consistent EMS guidelines for transport of stroke patients

Ohio Senate Bill 302 aims to ensure stroke patients are always transported to a hospital that is equipped to treat their condition


Laura Hancock
Advance Ohio Media, Cleveland

COLUMBUS, Ohio — Two treatments these days are highly effective for stroke patients: thrombolysis, administered through an IV up to 4.5 hours after the symptoms' onset, and mechanical thrombectomy, a minor surgery performed up to 24 hours after the stroke begins.

Not all Ohio hospitals are set up and certified to offer specialized stroke treatment, and where a patient ends up can vary, depending on the protocols of a local ambulance service.

A bill has been introduced in the Ohio Senate that would require EMS departments to develop consistent guidelines for assessing, triaging and transporting stroke patients. The aim of the bill is to ensure stroke patients are consistently transported to hospitals that are equipped to treat them.
A bill has been introduced in the Ohio Senate that would require EMS departments to develop consistent guidelines for assessing, triaging and transporting stroke patients. The aim of the bill is to ensure stroke patients are consistently transported to hospitals that are equipped to treat them. (AP Photo/Keith Srakocic)

A bill in the Ohio Senate aims for consistency and offering all Ohio stroke patients the best shot of recovery by requiring the Ohio State Board of Emergency Medical, Fire, and Transportation Services to develop guidelines on how emergency medical technicians assess stroke patients, provide triage and which hospitals they get transported to.

Senate Bill 302 sponsors Sens. John Eklund, a Geauga County Republican, and Nickie Antonio, a Lakewood Democrat, said in a virtual news conference Wednesday now is the right time to pass the bill.

"We have an aging population in the state of Ohio, and this bill really promotes the best practices for our citizens — the guidelines, the protocols to provide access to the best care in those precious moments when time really means life," Antonio said.

"We are ever mindful of the geographic and frankly resource diversity of our great state," Eklund said. "And, consequently, we're asking under the bill that the local EMS services would then be responsible for updating their protocols to be consistent with the guidelines that are established at the state level."

The bill was introduced in April, and time is running out. The two-year legislative session finishes soon, in what lawmakers call a "lame duck" session in which numerous bills are squeezed through around the December holidays, before new legislators are sworn in for a new session. Antonio said that SB 302 would be a good bill for lame duck because all the major medical organizations have helped work on it, so there won't be any last-minute negotiations necessary to get it passed.

In addition to being a leading cause of death, strokes are also a leading cause of disability.

"Most hospitals are equipped and able to handle IV thrombolysis," said Peter Rasmussen, a Cleveland Clinic neurosurgeon. "A subset of hospitals are available and equipped to handle mechanical thrombectomy. Establishing guidelines to have local EMS understand the severity of a stroke that a patient's having in the field and directing the transport of those patients to the appropriate resource in their community is highly critical to establishing the best care for the patients, and leading to the best outcome."

Patients treated with thrombolysis and mechanical thrombectomy have a higher chance of being able to return to their homes sooner, as opposed to needing long-term nursing care, and the health care over the rest of their lives is less expensive, he said.

SB 302 is in a Senate committee. In the Ohio House, Rep. Dave Greenspan said he's going to sponsor an identical bill.

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(c)2020 Advance Ohio Media, Cleveland

McClatchy-Tribune News Service

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