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Stroke Team Creation and Primary Stroke Center Certification


In June 1996, tissue-type plasminogen activator (t-PA; see alteplase) was the first drug to be approved by the US Food and Drug Administration (FDA) for the acute treatment of stroke. The initial NINDS trial showed efficacy for patients treated within the first 3 hours of onset of symptoms.
Subsequently, the ECASS III trial has shown benefit in individuals up to 4.5 hours from last known well,
making stroke treatment a true emergency. The short treatment window requires rapid evaluation of patients who may have had a stroke. Stroke teams have been created for this purpose.

The members of a stroke team vary depending on the needs of the individual hospital, although code team personnel often include 1 or more neurologists and nurses.

To achieve maximal efficiency, the team must integrate itself with the services and facilities involved in the care of patients with acute stroke, including the local community, emergency medical services (EMS), the emergency department (ED), interventional radiology (IR), neurosurgery, nursing, computed tomography (CT) scanning, laboratory, pharmacy, rehabilitation, and inpatient units.

The team educates the public and care providers about stroke warning signs and the availability of stroke treatments, evaluates and streamlines services, provides stroke treatment rapidly, and continually monitors the efficacy of its work. This article examines the creation of the stroke team and the role of the Primary Stroke Center in improving the delivery and coordination of care in acute stroke.

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