Arizona Adopts New Emergency Guidelines to Improve Stroke Triage


July 6, 2017—The Society of NeuroInterventional Surgery (SNIS) and its Get Ahead of Stroke public education and advocacy campaign announced that the state of Arizona has enacted new emergency guidelines that improve stroke triage to increase survival rates and reduce long-term care costs.

The Arizona Governor’s Regulatory Review Council has adopted a new rule to update emergency stroke care protocols that will change the way first responders triage and treat severe stroke patients across the state. According to the Get Ahead of Stroke campaign, the new guidelines encourage first responders to be trained in identifying severe stroke patients who are experiencing emergent large vessel occlusion (ELVO), then transport these patients to the facility best equipped to treat them. Previous guidelines steered stroke patients to the closest hospital, where many languished losing brain function while they awaited transport to a hospital equipped to perform neuroendovascular surgery.

The campaign noted that this rule will help reduce disability and death, as well as lower the costs associated with long-term health care. The rule update will take effect on August 6, 2017.

Felipe Albuquerque, MD, an endovascular neurosurgeon at Barrow Neurological Institute in Phoenix, Arizona, commented in the announcement, “Less than 10% of severe stroke patients nationwide are receiving potentially life-saving treatment because protocols that guide stroke treatment vary widely, making access to this treatment largely dependent on where patients live. This is a significant first step not only in improving outcomes but also in reducing the burden of health care costs on patients and on society.”

The updated Arizona guidelines are similar to how emergency medical services triage trauma patients. They are designed to help educate first responders to properly assess stroke severity in the field and to transport severe ischemic (ie, ELVO) stroke patients to the proper facilities. SNIS President Donald F. Frei, MD, stated, “Stroke—which is sometimes referred to as a brain trauma—should not be any different from trauma in terms of how we triage. These new rules will greatly improve the odds of these patients getting up and walking home the next day.”

The Get Ahead of Stroke campaign, which is working across the country to improve systems of care for all stroke patients by driving policy change and public awareness nationwide, also noted that the Colorado legislature unanimously passed a resolution encouraging the Colorado Department of Public Health and Environment to update its stroke protocols. Several other states have also updated, or are in the process of updating, their stroke care guidelines, including Rhode Island, Massachusetts, and Tennessee.


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