HYPER ACute Care
Hyper-acute care involves all direct care, service delivery, and interactions from first contact with the healthcare system after the onset of an acute stroke to the movement of the patient to the acute inpatient care. Specifically, during transport to the hospital and in the emergency department.
Over 1/3 of stroke patients do not contact emergency medical services for transport to a hospital and only 30% of patients arriving at the hospital are getting there within the 3.5 hour time frame to be eligible for acute thrombolysis. As a result, the time to brain imaging was prolonged and the time between hospital arrival and tPA administration was over 1 hour – exceeding the target 60 minute time frame. Canadian Stroke Best Practices Recommendations added the hyper-acute care guidelines with the aim to improve performance in these areas and reduce the time between stroke onset, arrival at a hospital, and treatment. The new hyper-acute stroke best practices are in place to help achieve this goal and improve outcomes for all stroke patients.
Inclusion Criteria for Acute Ischemic Stroke Treatment: Acute Thrombolytic Therapy with Intravenous Altephase & Endovascular Thrombectomy Treatment Criteria
- Absolute and Relative Inclusion Criteria checklist to guide clinical decision-making based in neuroimaging selection criteria
Prehospital Stroke Screening Tools: Standardized Acute Pre-Hospital Stroke Screening Tools
- 15 standardized acute pre hospital screening tools for clinicans
(ASPECTS): Understanding Alberta Stroke Program Early CT Score
- 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
Assessment Guide: Stroke Best Practice Pocket Assessment Guide
- Common signs and symptoms, types of stroke, Canadian Neurological Scale, NIH Stroke Scale, FAST signs
FAST-ED Training Module: West GTA Stroke Network e-learning module
- Provides a background on endovascular therapy for stroke
- Reviews changes in acute stroke care management and provides an overview of the FAST-ED App
The FAST-ED App is one tool for estimating the likelihood of large vessel occlusion and the utilization of this triage tool to promote efficient treatment with patients presenting with acute stroke symptoms.
Links to FAST ED app on the Apple Store and Google Play Store
STROKE BEST PRACTICES IN HYPER-ACUTE CARE
Core Information Required by Dispatch, Paramedics, and Receiving Healthcare Facility: Core Information
EMS Timelines (Pre-Hospital and Emergency Department Phases) for eligibility for acute ischemic stroke therapy: EMS Management of Acute Stroke Patients
Emergency Department Evaluation and Management: Emergency Department
Therapy: Acute Antiplatelet Therapy
Early Management of Patients Considered for Hemicraniectomy: Hemicraniectomy
Stroke Best Practices Website: Hyper-Acute Stroke Management Best Practices
Hyper-Acute Best Practice Update: 2018 update to guidelines for healthcare providers caring for people with current or recent symptoms of acute stroke or TIA
Canadian Stroke Best Practice Recommendations: Acute and Hyper-Acute Stroke Management Update 2018 PDF
HOT TOPICS IN HYPER-ACUTE CARE
Additional Resources for information about heart disease, stroke and healthy living:
EVIDENCE BASED RESOURCES
Links to analyses of stroke care:
New scientific articles and journals with research about hyper-acute stroke care and treatments
Hyper-Acute Operational Committee
This area is utilize by the Hyper-Acute Operational Committee members to communicate and share resources. If you are an operational committee member, please click on the button below.