Development of Stroke Transport Protocols

Stroke Systems of Care should include processes that provide rapid access to EMS for patients with acute stroke and that dispatch EMS in the shortest time possible, given local resource availability.

The Governor’s EMS and Trauma Advisory Council Stroke Committee recommends that the plan have 3 components that Regional Advisory Councils should implement:

1. Appointment of a “stroke committee” to develop and oversee a region-specific stroke transport plan.

2. The regional plan will conform to the following general principles:

a. A written plan is developed for regional triage of adult (TSA defines adult) stroke patients to hospitals best able to care for them.

b. Emergency transportation (immediate priority, most rapid transport or transfer) of patients out to 8 hours from symptom onset.  This time window can be altered as new therapies become available.

c. Instruct paramedics to take patients to the highest level state designated Stroke Center if available within the region (or adjacent region, if a higher level Stroke Center in the adjacent region is closer than a lower level Stroke Center in the region).  In making this determination, distance and time parameters should be considered.  There should be no more than a 15 minute delay caused by taking a patient to the next highest level of stroke care.  Where the available stroke care level and Stroke Centers/Facilities are comparable, a scheme should be developed to ensure a fair distribution of patients among qualified Stroke Centers/Facilities except for patient preference.

3. Create and maintain a registry of the number and destination of stroke patients transported and submit yearly to the DSHS.

Last Updated August 16, 2007