Updated Guidelines Issued for Care of Acute Ischemic Stroke

Guidelines detail stages of care, from recognition to emergency transport through early hospital care

THURSDAY, Jan. 31 (HealthDay News) -- For patients with acute ischemic stroke, the keys to limiting associated morbidity and mortality include the recognition of stroke, early diagnosis and treatment, and hospital care, according to updated guidelines published online Jan. 31 in Stroke.

On behalf of the American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Peripheral Vascular Disease, and Council on Clinical Cardiology, Edward C. Jauch, M.D., and colleagues reviewed the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke with the goal of limiting the morbidity and mortality associated with stroke. The guidelines supersede the 2007 guidelines and 2009 updates and are intended for prehospital care providers, physicians, allied health professionals, and hospital administrators.

According to the report, the guidelines endorse the concept of the stroke systems of care and describe phases of care from initial recognition of stroke; activation, transport, and triage of emergency medical services; through initial hospital care. Early stroke evaluation is discussed, as well as general medical care, ischemic stroke, specific interventions, and general physiological optimization for cerebral resuscitation. Consistent with previous guidelines, the report recommends that evaluation is completed and fibrinolytic treatment initiated within 60 minutes of arrival in an emergency department.

"For an individual patient, this document draws on the 2010 advanced cardiac life support stroke chain of survival, which describes the critical links to the process of moving a patient from stroke ictus through recognition, transport, triage, early diagnosis and treatment, and the final hospital disposition," the authors write.

Several authors disclosed financial ties to the pharmaceutical and health care industries.

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