The American Hospital Association (AHA) has established new guidelines for managing patients who are suspected of haviong suffered a stroke. Eligible patients presenting to the hospital with ischemic stroke should receive recombinant tissue plasminogen activator (rTPA) within 60 minutes of arrival, according to the new ischemic stroke guidelines.
Published in Stroke, the guidelines include the following new or revised recommendations:
• Patients with suspected stroke should be quickly taken to the closest certified primary stroke center or comprehensive stroke center. If no such centers exist, they should be taken to the most appropriate institution that provides emergency stroke care.
• In community hospitals without onsite stroke expertise, telestroke consultation together with stroke education and training for clinicians could help increase use of rTPA.
• Intravenous fibrinolysis may be considered in patients with mild stroke deficits, rapidly improving stroke symptoms, major surgery in the prior 3 months, and recent myocardial infarction.
• Efforts should be made to reduce the time from symptom onset to reperfusion with intra-arterial therapies.