UTSW/BioTel EMS TRAINING BULLETIN
September 2014

EMS TB 14-004 Evaluation/Transport of a Patient with Signs & Symptoms of ACUTE STROKE   (PDF Here)

Purpose:

  1. All Dallas-area receiving hospitals are currently focused on improving the emergency management of patients who may be suffering from ACUTE STROKE.  In order to assist the receiving hospital staff in preparing for the arrival of an acute stroke patient.

Training Points:

  1. Paramedics shall notify BioTel or the receiving hospital directly, as early as possible, during the course of treatment and transport.  Advise BioTel or the receiving hospital that you are en route with a patient that has signs and symptoms consistent with an ACUTE STROKE.
  2. The most important information to gather:

    "When did the symptoms begin?"
    - or -
    "When was patient last seen normal?"

If the patient cannot communicate the time, or there is no witness present to report “Last Known Normal”, obtain a phone number for such a witness, if possible.

Additional information to obtain:

Primary Vs. Comprehensive/Comprehensive-Capable Stroke Centers

 

Primary Stroke Center

Comprehensive or Comprehensive–Capable Stroke Center

Takes care of:

Most patients with acute ischemic stroke

All types of stroke

Neurosurgery Capability

Within 2 hours

24/7

Stroke Intensive Care Unit

Not required

Required

Ability to Perform Non-invasive Catheter Procedures

Not required

Required

Time from symptom onset for direct transport

<3.5 hours OR >12 hours

Any time frame if it is the closest Stroke and preferentially for patients with symptom onset 3.5 to 12 hours.

 

For a complete listing of area hosptals and their stroke capabilities, click here.

 

Documentation regarding destination decision-making:

It is essential that paramedics document on the EPCR the following information:

  1. Last known normal time
  2. The reason why a patient was transported to a particular Stroke Center. For example: This patient was transported to the closest Comprehensive Capable Stroke Center because he had symptoms for 6 hours.