"Stroke teams" are groups of healthcare professionals, often led by neurologists, who work together to overcome the multiple barriers that commonly prevent people from getting timely stroke treatment. To accomplish this, acute stroke teams must not only design ways to optimize the transport, diagnosis and management of stroke patients inside a hospital, but educate other physicians and the public at large.
The Stroke Team Philosophy: Time is BrainTime is the enemy after a stroke, as the most effective form of treatment available, t-PA (a medication used to dissolve blood clots), must be delivered within 3 hours of the time the stroke symptoms first appear. If given later, it is not effective, and it can cause major bleeding inside the brain. Because of this, stroke doctors fully understand the concept that "time is brain," as once a person has suffered a stroke, every minute that passes by is one minute lost in this precious 3-hour window. Unfortunately, fewer than 5% of stroke patients are able to obtain t-PA treatment. Why is this?
Common Reasons for Missing The Golden Three-Hour Window
- Over 60% of people who suffer a stroke wait more than 24 hours before seeking medical attention. This decision is commonly based on the hope that stroke symptoms will "just go away."
- Some people who suffer a stroke decide to walk into their doctor’s office the day of, or the day after their symptoms arise.
- There are delays in the emergency room, such as difficulties obtaining a CT scan of the brain, or other tests which are required for the diagnosis of stroke.
Acute Stroke Teams Improve the Efficacy of Stroke CareThe primary goal of the acute stroke team is to improve the efficiency with which stroke treatments are provided. To accomplish this goal, the acute stroke team performs the following tasks in a hospital:
- Educate patients, physicians and other healthcare professionals about the warning signs of stroke and the availability of t-PA and other stroke treatments.
- Evaluate stroke treatments in a hospital in order to identify systematic problems and generate solutions for them.
- Design and implement stroke treatment protocols that involve a unified effort among ambulance services, emergency room personnel, the hospital’s laboratory, nurses, pharmacists, radiologists, and the acute stroke team itself.
- Ensure that “ultrarapid” acute stroke treatment is provided around the clock for all qualified patients.
- Ensure long-term follow-up of stroke patients treated in the hospital in order to assess the health of these individuals after treatment.
Benefits of Having an Acute Stroke TeamThere are several benefits, both for hospitals and for the public at large, of having acute stroke teams in place:
- Community education and awareness about stroke symptoms, and the need to treat them as medical emergencies.
- Prevention of long-term disability for members of the hospital's local community.
- Systematic evaluation of stroke patients to ensure that t-PA can be given to those patients who can benefit from it.
- Reduction in the overall cost of stroke treatment in the United States.
- Continuous update of new stroke therapies and public health efforts provided by a hospital to its community.
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C. S. Kidwell, MD, T. Shephard, RN MSN, CNRN, CNS, S. Tonn, MPH, B. Lawyer, BA, M. Murdock, BA, W. Koroshetz, MD, M. Alberts, MD, G. J. Hademenos, PhD and J. L. Saver, MD; Establishment of primary stroke centers. A survey of physician attitudes and hospital resources Neurology 2003;60:1452-1456.
Wayne Clark, MD; Acute Stroke Team Journal of Stroke and Cerebrovascualar Diseases, Vol 8, No3 (May-June), 1999 pp 111-113.