ED: Stroke management guidelines

Submitted by Steven J. Gamburg, MD, FACEP, Chair, Department of Emergency Medicine


While all four MLH acute care hospitals have stroke center certification, patients requiring neurointerventional care are transferred to Bryn Mawr Hospital, the first hospital in the western suburbs to have a university-affiliated neurosciences center for comprehensive stroke care. Through our collaboration with the Jefferson Neuroscience Network, our center is designed to give rapid access to advanced diagnostics and the latest neurovascular treatments.


From our recent System Stroke meeting, here are some key updated points on “stroke alert” and “Interventional Stroke Alert”:

  • Call a stroke alert if less than 4.5 hour window with symptoms of cva
  • Most patients will fall out of the stroke tpa window of 4.5 hours but may be candidates for acute intervention in the 12 hour window
  • For our data to be consistent across the 4 ER’s and for meaningful data, please call an “Interventional Stroke Alert” any time you call Dr Gould.


The recommendation is:

“Call an interventional stroke alert if the patient is not a candidate for tPA, having symptoms and within the 12 hour window.”

Read the Guidelines here.

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