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Stroke, Vol 25, 1920-1923, Copyright © 1994 by American Heart Association

ARTICLES

Code stroke. An attempt to shorten inhospital therapeutic delays

CR Gomez, MD Malkoff, CM Sauer, R Tulyapronchote, CM Burch and GA Banet
Souers Stroke Institute, Saint Louis University Health Sciences Center, MO 63110.

BACKGROUND AND PURPOSE: Significant delays often occur during the treatment of patients with acute stroke. Some of those delays occur in the hospital. We attempted to shorten inhospital treatment intervals by creating a rapid-response system, similar to that available for cardiac arrest, that would allow the stroke team to be available within a few minutes to care for stroke victims. METHODS: We connected all beepers (pocket pagers) of stroke team members to a common access number and instructed the emergency staff to activate that number immediately upon arrival of a stroke victim. We monitored the response time and treatment interval for patients who were treated after this system was activated (Code Stroke patients) during the first 3 months of its availability and compared the results to those of patients seen for similar reasons during the study period but without the use of Code Stroke (control patients). RESULTS: A total of 12 Code Stroke patients were available for analysis, representing 12% of all patients (n = 98) seen in the emergency department for ischemic stroke during the study period. The remaining 86 patients constituted the control group. The mean time to evaluation of a Code Stroke patient by a stroke team member was 4.8 minutes (range, 2 to 7 minutes), and the mean time to treatment institution was 30 minutes (range, 10 to 120 minutes). There were significant differences between the consultation intervals in the two groups (P < .05). There was only a trend of a difference between treatment institution intervals (P = .06). CONCLUSIONS: It is possible to shorten inhospital treatment delays by instituting rapid-response systems within individual institutions.

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