title: Pre- and in-hospital intersection of stroke care.
abstract: Acute ischemic stroke is a time-critical emergency for which thrombolytic therapy is the only medical treatment. Many patients who would benefit from this treatment are deprived of it due to delays. Failure to call for help rapidly is the main obstacle, but even when the call is made in time, the prehospital evaluation, transportation, and emergency department (ED) diagnostics often take too long to treat the patient with thrombolysis. Interventions to reduce pre- and in-hospital delays have been described; although no single intervention is likely to make a major difference, a whole set of interventions needs to be implemented. The intersection of the pre- and in-hospital care is of special importance. With successful protocols and good communication between the emergency medical service and ED, delays can be significantly reduced. On the basis of our experience, 94% of patients can be treated within 60 min of arrival, based largely on using the prehospital time effectively.
authors.affiliation: Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: Atte
authors.initials: A
authors.lastname: Meretoja
authors.forename: Markku
authors.initials: M
authors.lastname: Kaste
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D002544:Cerebral Infarction / Q000209:etiology / Q000517:prevention & control; D004630:Emergencies; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D010348:Patient Care Team; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator