The following are key points to remember from this American Heart Association (AHA) Scientific Statement about acute stroke management in patients with in-hospital stroke:
- Approximately 2-4% of patients with stroke have their event while hospitalized for another condition, with almost one half resulting from a vascular procedure.
- Suspected stroke symptoms can be confounded by medications, metabolic encephalopathy, and comorbid conditions.
- Time from symptom onset to stroke alert is delayed in in-hospital stroke.
- All hospital staff should be empowered to activate stroke alerts in the inpatient setting.
- Educating staff on the use of evidence-based rapid screening tools may improve accurate evaluation of patients suspected of in-hospital stroke.
- Patients with suspected in-hospital stroke require acute management in accordance with current AHA/American Stroke Association treatment guidelines.
- Hospitals unable to provide acute stroke treatment in the inpatient setting need to engage leadership, identify key barriers, and develop the appropriate pathways to facilitate and expedite necessary transfer to a higher level of care.
- Regional stroke systems of care should include protocols and algorithms for transfer and treatment of patients with in-hospital stroke from spoke to hub hospitals.
- Telemedicine should be considered for in-hospital stroke code evaluation when adequate, timely expertise is unavailable.
- Optimizing response time and health care resource stewardship and improving adherence to consensus quality measures are key areas of emphasis for quality improvement.
- Nouh A, Amin-Hanjani S, Furie KL, et al.
- Identifying Best Practices to Improve Evaluation and Management of In-Hospital Stroke: A Scientific Statement From the American Heart Association. Stroke 2022;Feb 9:[Epub ahead of print].
- Twitter: @DrNabilPaktin
Post a Comment