ABC: časopis urgentne medicine (Jan 2024)

Prehospital care of patients with acute stroke

  • Lučić-Prokin Aleksandra,
  • Petrović Radmila,
  • Jokšić-Mazinjanin Radojka,
  • Dragosavac Boris,
  • Živanovic Željko

DOI
https://doi.org/10.5937/abc2402028P
Journal volume & issue
Vol. 24, no. 2
pp. 28 – 35

Abstract

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An acute stroke (ischemic or hemorrhagic) is an urgent neurological condition that should be treated as a matter of urgency. The generally accepted therapy of acute ischemic stroke (IS) is intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) of a large vessel occlusion, if applied within a defined period of time (4.5 hours for IVT and up to 6 hours for EVT). In order to start treatment as early as possible, prehospital procedures and rapid transport by the Emergency Medical Service (EMS) to the appropriate health facility have a promising functional outcome. The goal of the article is aimed at optimizing all prehospital components in providing high-quality care for the patients with acute stroke. The stroke chain of survival has several links: laypersons stroke recognition, telephone contact with the EMS dispatcher, approximately accurate prehospital classification of stroke by dispatchers and EMS doctors, clinical and therapeutic procedures in the ground, triage and rapid transport of patients. Modern technologies, which are adapted to prehospital conditions (mobile stroke units and telemedicine), can help optimize this phase of stroke treatment. Regardless of these new technologies, outcomes of stroke can be improved by further optimizing existing prehospital care systems, which could be achieved by incorporating EMS into the overall health system. The feedback on the undertaken procedures and the functional outcome of patients would significantly influence the optimization of the pre-hospital phase of stroke. In our conditions, developing the regionalization of the stroke care network with the involvement of public health management and the education of medical personnel, is a key to the initiative implemented by many health systems in the world. The collaboration of all involved professionals, from triage staff, medical technicians, dispatchers, EMS doctors in the ground and those in health centers, should become one of the goals in our cooperation.

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