How should EMS decide transport destination for suspected stroke?

How should EMS decide transport destination for suspected stroke?

• A. Consider large vessel occlusion probability; transport to EVT-capable center if high probability, else follow local routing
• B. Always transport to nearest hospital regardless of LVO probability
• C. Transport only to designated stroke centers after phone call
• D. Delay transport for imaging at arrival

Answer: (C)

The key idea is getting suspected stroke patients to a facility that can rapidly evaluate and treat them, with the receiving team already activated before arrival. Transmitting to a designated stroke center and making a pre-arrival phone call lets the hospital prepare the CT scan, stroke team, and treatment plan so imaging and reperfusion therapy can begin immediately upon arrival. This minimizes door-to-needle and door-to-imaging delays, which are critical for preserving brain tissue. Choosing a designated stroke center after notifying them ensures the patient isn’t taken to a hospital that lacks the full acute-stroke capabilities, reducing wasted time trying to arrange care after arrival. Transporting to the nearest hospital regardless of stroke capabilities can lead to delays in imaging and therapy. Delaying transport to perform imaging on arrival is not optimal either, since treatment decisions depend on rapid imaging and on-scene time is limited. So, routing to a designated stroke center with pre-notification aligns with delivering rapid, appropriate care and maximizing the chance for a favorable outcome.

The key idea is getting suspected stroke patients to a facility that can rapidly evaluate and treat them, with the receiving team already activated before arrival. Transmitting to a designated stroke center and making a pre-arrival phone call lets the hospital prepare the CT scan, stroke team, and treatment plan so imaging and reperfusion therapy can begin immediately upon arrival. This minimizes door-to-needle and door-to-imaging delays, which are critical for preserving brain tissue.

Choosing a designated stroke center after notifying them ensures the patient isn’t taken to a hospital that lacks the full acute-stroke capabilities, reducing wasted time trying to arrange care after arrival. Transporting to the nearest hospital regardless of stroke capabilities can lead to delays in imaging and therapy. Delaying transport to perform imaging on arrival is not optimal either, since treatment decisions depend on rapid imaging and on-scene time is limited.

So, routing to a designated stroke center with pre-notification aligns with delivering rapid, appropriate care and maximizing the chance for a favorable outcome.