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Related Experiment Videos

Regional access to acute ischemic stroke intervention.

R J Riopelle1, D C Howse, C Bolton

  • 1Queen's University Care Delivery Network Project, and Division of Neurology, Kingston General Hospital, Kingston, Canada. riopelle@post.queensu.ca

Stroke
|March 10, 2001
PubMed
Summary
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Implementing a Regional Acute Stroke Protocol (RASP) improved access to timely recombinant tissue plasminogen activator (rtPA) treatment for acute ischemic stroke patients, overcoming geographical barriers in Southeastern Ontario.

Area of Science:

  • Neurology
  • Emergency Medicine
  • Public Health

Background:

  • Recombinant tissue plasminogen activator (rtPA) therapy for acute ischemic stroke is time-sensitive, with reduced efficacy beyond 3 hours.
  • Equitable access to rtPA is crucial for improving patient outcomes in large geographical areas.

Purpose of the Study:

  • To enhance therapeutic effectiveness of rtPA by ensuring equitable access for acute ischemic stroke patients.
  • To establish a coordinated regional system response for stroke care within a large referral base.

Main Methods:

  • Development of a Regional Acute Stroke Protocol (RASP) involving all emergency medical services providers.
  • Implementation of a system where ambulances bypass local hospitals to transport eligible patients directly to a tertiary facility.

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Main Results:

  • After 12 months, 403 ischemic strokes occurred, with 191 RASP activations.
  • 42 patients received rtPA, representing 5% of all acute strokes and 10% of ischemic strokes in the region.
  • Ambulance services began bypassing closest hospitals to deliver patients to Kingston General Hospital.

Conclusions:

  • Acute stroke patients in Southeastern Ontario demonstrated improved access to stroke interventions.
  • Geographical barriers were overcome, proving that regional systems can ensure access to time-critical stroke care.
  • rtPA treatment was administered to a significant percentage of eligible acute ischemic stroke patients within the region.