title: Translation of the 'time is brain' concept into clinical practice: focus on prehospital stroke management.
abstract: Acute stroke is one of the main causes of death and chronic disability. Thrombolysis with recombinant tissue plasminogen activator within the first hours after onset of symptoms is an effective therapeutic option for ischemic stroke. However, fewer than 2% to 7% of patients receive this treatment, primarily because most patients reach the hospital too late for the initiation of successful therapy. Several measures can reduce detrimental delay until treatment. It is of importance to use continual public awareness campaigns to reduce delays in patients' alarm of emergency medical services. Further relevant measures are repetitive education of emergency medical services teams to ensure the systematic use of scales designed for recognition of stroke symptoms and the proper triage of patients to stroke centers. A most important time-saving measure is prenotification of the receiving hospital by the emergency medical services team. In the future, treatment already at the emergency site may allow more than a small minority of patients to benefit from available treatment.
authors.affiliation: Department of Neurology, University Hospital of the Saarland, Homburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Ragoschke-Schumm
authors.forename: S
authors.initials: S
authors.lastname: Walter
authors.forename: A
authors.initials: A
authors.lastname: Haass
authors.forename: C
authors.initials: C
authors.lastname: Balucani
authors.forename: M
authors.initials: M
authors.lastname: Lesmeister
authors.forename: A
authors.initials: A
authors.lastname: Nasreldein
authors.forename: L
authors.initials: L
authors.lastname: Sarlon
authors.forename: A
authors.initials: A
authors.lastname: Bachhuber
authors.forename: T
authors.initials: T
authors.lastname: Licina
authors.forename: I Q
authors.initials: IQ
authors.lastname: Grunwald
authors.forename: K
authors.initials: K
authors.lastname: Fassbender
mesh_terms: D000818:Animals; D001921:Brain / Q000473:pathology*; D019468:Disease Management; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D057170:Translational Research, Biomedical
keywords: emergency medical service; mobile stroke unit; prehospital phase; stroke management; thrombolysis