title: Code stroke. An attempt to shorten inhospital therapeutic delays.
abstract: OBJECTIVE
  Significant delays often occur during the treatment of patients with acute stroke. Some of those delays occur in the hospital. We attempted to shorten inhospital treatment intervals by creating a rapid-response system, similar to that available for cardiac arrest, that would allow the stroke team to be available within a few minutes to care for stroke victims.
  
  
  METHODS
  We connected all beepers (pocket pagers) of stroke team members to a common access number and instructed the emergency staff to activate that number immediately upon arrival of a stroke victim. We monitored the response time and treatment interval for patients who were treated after this system was activated (Code Stroke patients) during the first 3 months of its availability and compared the results to those of patients seen for similar reasons during the study period but without the use of Code Stroke (control patients).
  
  
  RESULTS
  A total of 12 Code Stroke patients were available for analysis, representing 12% of all patients (n = 98) seen in the emergency department for ischemic stroke during the study period. The remaining 86 patients constituted the control group. The mean time to evaluation of a Code Stroke patient by a stroke team member was 4.8 minutes (range, 2 to 7 minutes), and the mean time to treatment institution was 30 minutes (range, 10 to 120 minutes). There were significant differences between the consultation intervals in the two groups (P < .05). There was only a trend of a difference between treatment institution intervals (P = .06).
  
  
  CONCLUSIONS
  It is possible to shorten inhospital treatment delays by instituting rapid-response systems within individual institutions.
authors.affiliation: Souers Stroke Institute, Saint Louis University Health Sciences Center, MO 63110.
authors.forename: C R
authors.initials: CR
authors.lastname: Gomez
authors.forename: M D
authors.initials: MD
authors.lastname: Malkoff
authors.forename: C M
authors.initials: CM
authors.lastname: Sauer
authors.forename: R
authors.initials: R
authors.lastname: Tulyapronchote
authors.forename: C M
authors.initials: CM
authors.lastname: Burch
authors.forename: G A
authors.initials: GA
authors.lastname: Banet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006747:Hospital Communication Systems / Q000458:organization & administration; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D010348:Patient Care Team; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors