North Carolina Updates Stroke Triage and Transport Protocol to Reduce Death and Disability

FAIRFAX, Va., Oct. 18, 2021 /PRNewswire/ -- North Carolina has updated its emergency stroke care protocol, a move applauded by the Get Ahead of Stroke® campaign. The protocol, which went into effect October 15, will change the way first responders triage and transport severe stroke patients across the state.

The Stroke and LVO Stroke EMS Triage and Destination Plan will help ensure that patients experiencing a severe stroke — including a deadly ischemic stroke such as a large vessel occlusion (LVO)  — will be effectively triaged and transported to the hospital that is best-equipped to treat them. Until now, the state did not have specific guidance in place to help ensure these particular patients were triaged and transported to a Level 1 stroke center — the most appropriate care facility for treating LVO. The updated protocol will help "minimize the time from stroke onset to definitive care."

"I can attest to the impact of transport delays on prolonging and exacerbating the effects of stroke," said Dr. Katyucia de Macedo Rodrigues, a neurointerventionalist at Greensboro Radiology – Cone Health Moses Cone Hospital, and member of the Society of NeuroInterventional Surgery (SNIS). "For every minute of delay in treating severe ischemic stroke such as large vessel occlusion, two million brain cells die. With each hour that passes before the patient is properly treated, the brain loses as many neurons as it does in almost 3.6 years of normal aging."

Stroke is a leading cause of death in North Carolina. Growing research shows, however, that severe stroke patients' outcomes can be significantly improved when they are treated with mechanical thrombectomy — a minimally invasive procedure that quickly removes the clot in the brain responsible for the stroke and restores blood flow. North Carolina's updated protocol will help improve timely access to this life-saving treatment for patients afflicted with severe stroke such as LVO.

The updated protocol was developed through a collaborative effort involving members of SNIS, the Justus-Warren Heart Disease and Stroke Prevention Task Force, and the North Carolina Division of Public Health. It advises EMS to utilize a stroke severity tool and score when conducting an initial assessment of a stroke patient. If there is a high likelihood the patient has a large vessel occlusion based on their severity score, EMS should transport them directly to a Level 1 stroke center.

The protocol allows flexibility for each EMS agency to collaborate with stroke centers to where they routinely transport patients in developing guidelines most appropriate for the region based on geography and available stroke resources. The Get Ahead of Stroke® campaign, a national public education and advocacy campaign designed to improve systems of care for stroke patients, says the updated protocol will help improve North Carolinians' chances of surviving severe stroke, as well as lower the immense costs associated with long-term care and rehabilitation services.

"We commend our SNIS colleagues as well as the Justus-Warren Heart Disease and Stroke Prevention Task Force, State Senator Jim Perry (R-7), and the North Carolina Division of Public Health for their commitment and dedication to improving how patients afflicted with severe stroke are triaged and transported in the state," said Dr. Michael Chen, a neurointerventionalist and the president of the Society of NeuroInterventional Surgery (SNIS). "It is a remarkable achievement that residents of North Carolina should be proud of."

Similar protocols addressing the unique, time-sensitive needs of stroke patients with LVO also have been adopted in states such as Arizona, Colorado, Florida and Tennessee, and are in process in Ohio. The Get Ahead of Stroke^® campaign is currently supporting similar protocol changes in Massachusetts, Michigan and Pennsylvania. 

Get Ahead of Stroke^® is a national public education and advocacy campaign designed to improve systems of care for stroke patients. Founded in 2016 by the Society of NeuroInterventional Surgery (SNIS), today the campaign is supported by a coalition of organizations with the goal of securing the best possible outcomes for stroke patients by driving policy change and public awareness nationwide.

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SOURCE Get Ahead of Stroke