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Code stroke in Asturias.

L Benavente1, M J Villanueva2, P Vega3

  • 1Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España.

Neurologia (Barcelona, Spain)
|September 24, 2015
PubMed
Summary
This summary is machine-generated.

Code stroke modifications in Asturias improved access to reperfusion therapies for ischemic stroke patients. This reorganization optimized treatment times and ensured equitable, safe care, enhancing patient outcomes.

Keywords:
Code strokeCódigo ictusFibrinolysisFibrinólisisGravedad-tiempoHealth districtSeverity-timeThrombectomyTrombectomíaÁreas sanitarias

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Public Health

Background:

  • Intravenous thrombolysis with alteplase is effective for ischemic stroke within 4.5 hours, but access is limited (<15%).
  • Mechanical thrombectomy offers higher recanalization rates for large vessel occlusions but requires specialized infrastructure, further limiting availability.

Purpose of the Study:

  • To describe the implementation of a revised "code stroke" protocol in Asturias.
  • To adapt existing resources for urgent stroke care, optimizing treatment times and patient management based on regional factors.

Main Methods:

  • Reorganized the "code stroke" protocol across 8 health districts in Asturias.
  • Established 24-hour stroke units with on-call neurologists for IV fibrinolysis.
  • Implemented a triage system using the NIHSS score by pre-hospital emergency services.
  • Directed severe cases to hospitals with interventional neurology care.

Main Results:

  • Reperfusion therapies were successfully applied following protocol modifications.
  • Equitable care was emphasized, balancing patient severity with treatment time.
  • Optimized patient referral based on proximity and stroke severity.

Conclusions:

  • The modified "code stroke" protocol in Asturias has led to good outcomes with reperfusion therapies.
  • The strategy effectively manages the severity-time ratio for prompt and safe stroke treatment.
  • Enhanced access to timely and appropriate stroke care for patients in the region.