Acute care is where the person is stabilized, diagnosis confirmed, plans are implemented to prevent complications, and when initial rehabilitation and recovery begin.
Acute Stroke Care refers to the key interventions involved in the assessment, treatment or management, and early recovery in the first days after stroke onset.
The primary aims of the acute phase of care are to identify the nature and mechanism of stroke, prevent further complications, promote early recovery and in the case of the severest strokes provide end-of-life care. Secondary prevention plans and engagement with patients and family to transition to the next level of care is undertaken.
Working Together with Stroke Survivors and their Caregivers to Achieve Optimal Outcomes is imperative across stroke systems of care, with the participation of individuals with stroke, their families and caregivers, healthcare providers, and the broader community. The primary underpinnings of ‘acute inpatient stroke care’ are to optimize recovery and patient outcomes (Canadian Best Practice Recommendations, October 2015)
Acute Inpatient Stroke Care
Achieving optimal outcomes for stroke survivors requires patients to be cared for on dedicated inpatient stroke units by healthcare team members with specialized stroke training, and establishment of evidence-based stroke protocols for all aspects of stroke care, including team meetings with case reviews, and early access to rehabilitation assessments and therapies. Hospitals that manage stroke patients and currently do not have dedicated stroke units should strive to implement all the core elements of stroke unit care, regardless of whether there is a designated stroke unit, and at least cluster stroke patients within a consistent area of a hospital ward and provide staff with education and skills training specific to stroke care. In hospitals where this goal is not possible within, acute stroke patients should be transferred to the nearest hospital that does provide acute stroke unit care. (Canadian Best Practice Recommendations, October 2015)
Tools to help primary-care providers with assessment, intervention, and communication with acute stroke patients.
AFIM: AFIM Info Poster
AFIM: FAQ's for Clinicians
Depression screening: Assess Mood Depression
Understanding Alberta Stroke Program Early CT Score: (ASPECTS)
- 10 point qualitative score for the detection and assessment of early ischemic changes on non-contrast head CT to determine patient eligibility for receiving interventional mechanical thrombectomy treatment
Stroke Best Practice Pocket Assessment Guide: Assessment Guide
- Common signs and symptoms, types of stroke, Canadian Neurological Scale, NIH Stroke Scale, FAST signs
NIH Stroke Scale: Stroke Scale PDF
- Clinical stroke assessment tool to evaluate and document neurological status in acute stroke patients
Intro to Supportive Conversation for Adults with Aphasia: Self-Directed Learning Module
Stroke Engine Acute Stroke Assessment: Assessment Review and Guide
Stroke Engine Acute Stroke Interventions: Intervention Review and Guide
CorHealth Ontario: Resources for Acute Stroke Care Providers
STROKE BEST PRACTICES IN ACUTE CARE
Acute Care Best Practice Update: Acute Stroke Management Best Practice
- 2018 update to guidance to healthcare providers caring for people with current or recent symptoms of acute stroke or TIA
PDF link to full Acute Stroke Management Update 2018: Acute Stroke Management update PDF
Acute Stroke Management Evidence Tables: Evidence Tables PDF
Stroke Best Practice Website: Stroke Best Practices
Secondary Prevention of Stroke Best Practice: Revised Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke
HOT TOPICS IN ACUTE
Additional Resources for information about heart disease, stroke and healthy living:
EVIDENCE BASED RESOURCES
Links to websites with analyses of stroke care:
Graded Repetitive Arm Supplementary Program (GRASP): GRASP Research Evidence
Quality-Based Procedures Clinical Handbook for Stroke: Clinical Handbook PDF
Review of Stroke Rehabilitation: Evidence-based Review of Stroke Rehabilitation
- “Comprehensive and up-to-date review of research regarding therapy-based and pharmacological interventions associated with stroke rehabilitation”
New scientific articles and journals with research about acute stroke care
Acute Operational Committee
This area is utilize by the Acute Operational Committee members to communicate and share resources. If you are an operational committee member, please click on the button below.