6
Stroke Systems of Care
and Prehospital Management
2.2. EMS Systems
COR LOE
Recommendations
1 B-NR
1. Health care policy makers should establish regional systems
of stroke care to increase access to time-sensitive therapies
that include the determination of: a) health care facilities
that provide initial emergency care, including administration
of IVT, and b) centers capable of performing endovascular
stroke treatment with comprehensive periprocedural care to
which rapid transport must be arranged when appropriate.
1 B-NR
2. EMS leaders, together with local experts, regional or state
agencies, and medical authorities, should develop prehospital
triage protocols to ensure that patients with suspected stroke
are rapidly identified, assessed with a validated tool for
stroke screening, and preferentially transported to the most
appropriate stroke centers.
2a B-NR
3. Monitoring and feedback on quality metrics related to
prehospital care can be useful to reduce delays from symptom
onset to ischemic stroke reperfusion treatment and increase
the odds of discharge to home.
Note: "New and of High Impact " indicates new and practice-changing
recommendations since the last iteration of the guideline; not a comprehensive
list of all updates.
