A survey and analysis of pediatric stroke protocols

Area of Science:

• Pediatric Neurology
• Stroke Medicine
• Healthcare Quality Improvement

Background:

• Pediatric ischemic stroke affects approximately 10,000 children annually.
• Standardized treatment protocols for pediatric stroke are lacking, unlike in adults.
• Existing adult stroke protocols have not been adequately evaluated for pediatric use.

Purpose of the Study:

• To determine the prevalence of pediatric stroke protocols in hospitals.
• To analyze the diagnostic and treatment components within these protocols.
• To identify areas of consensus and disagreement in pediatric stroke management.

Main Methods:

• An 18-question survey was distributed to physicians in relevant specialties at 50 pediatric hospitals.
• Participants included neurology, neurosurgery, radiology, pediatric intensive care, and emergency medicine.
• Consensus was defined as agreement among over 75% of respondents.

Main Results:

• Out of 264 surveys, 93 were returned (35%), representing 46 hospitals.
• 82% of responding hospitals reported having a pediatric stroke protocol.
• Consensus was achieved on 9 components, including intravenous tissue plasminogen activator and mechanical thrombectomy, but not on screening tools or contact methods.

Conclusions:

• The majority of pediatric hospitals have implemented stroke protocols.
• Significant lack of consensus exists regarding key elements of pediatric stroke diagnosis and treatment protocols.
• Further standardization is needed to improve early and effective management of pediatric ischemic stroke.