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The logic of having a multitiered system such as that provided for trauma was evident.
Therefore, in 2005 the Brain Attack Coalition followed the statement on primary stroke centers with recommendations for comprehensive stroke centers.
Following the establishment of primary stroke centers and comprehensive stroke centers, the new concept of a stroke-prepared hospital has recently emerged.
This stroke-prepared hospital can access stroke expertise via telemedicine.
Additional work is needed to expand the reach of regional stroke networks.
Healthcare professionals working in EMS, emergency medicine, or emergency nursing can also assist in this process by determining which hospitals in their community offer care concordant with the Brain Attack Coalition recommendations for primary stroke centers.
The signs and symptoms of stroke include sudden weakness or numbness of the face, arm, or leg, especially on one side of the body; sudden confusion; trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or sudden severe headache with no known cause.
It is imperative that the stroke system of care provide education and training to 911 and EMS personnel to minimize delays in prehospital dispatch, assessment, and transport.
A sweep hand depicts the goal in minutes from ED arrival to task completion to remind the clinician of the time-sensitive nature of management of acute ischemic stroke.
The sections below summarize the principles and goals of stroke system development and emergency assessment and management, as well as highlight new recommendations and training issues.
Identifying clinical signs of possible stroke is important because recanalization strategies (intravenous [IV] fibrinolysis and intra-arterial/catheter-based approaches) must be provided within the first few hours from onset of symptoms.
Patient education efforts are most effective when the message is clear and succinct.
For additional information about the management of acute ischemic stroke, see the American Heart Association (AHA)/American Stroke Association (ASA) guidelines for the management of acute ischemic stroke.