Acute code stroke activations seen in the emergency department: how often are we missing the mark?

Area of Science:

• Neurology
• Emergency Medicine
• Healthcare Management

Background:

• Code stroke activations mobilize critical healthcare resources.
• Evaluating compliance with code stroke criteria is essential for resource optimization.
• Previous studies have not fully assessed non-compliant activations and their impact on acute stroke care.

Purpose of the Study:

• To determine the proportion of non-compliant code stroke activations.
• To analyze acute treatments and healthcare utilization following non-compliant activations.
• To identify factors contributing to non-compliant code stroke activations.

Main Methods:

• A multicentre health records review was conducted.
• Adult patients experiencing code stroke activations in emergency departments (ED) were analyzed.
• Non-compliant activations were defined as those not meeting institutional criteria.

Main Results:

• 30.5% of 1028 code stroke activations were non-compliant.
• Incorrect last seen normal time determination was the primary cause of non-compliance.
• Non-compliant activations were less likely to receive reperfusion therapy or stroke unit admission.

Conclusions:

• A significant proportion of code stroke activations are non-compliant with established criteria.
• Simplifying protocols and utilizing simulation exercises can improve adherence.
• Reducing non-compliant activations can conserve vital healthcare resources and improve patient care pathways.