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The Extended Treatment Window’s Impact on Emergency Systems of Care for Acute Stroke
dc.contributor.authorMiller, Joseph B.
dc.contributor.authorHeitsch, Laura
dc.contributor.authorMadsen, Tracy E.
dc.contributor.authorOostema, John
dc.contributor.authorReeves, Mat
dc.contributor.authorZammit, Christopher G.
dc.contributor.authorSabagha, Noor
dc.contributor.authorSozener, Cemal
dc.contributor.authorLewandowski, Christopher
dc.contributor.authorSchrock, Jon W.
dc.date.accessioned2019-08-09T17:12:37Z
dc.date.availableWITHHELD_12_MONTHS
dc.date.available2019-08-09T17:12:37Z
dc.date.issued2019-07
dc.identifier.citationMiller, Joseph B.; Heitsch, Laura; Madsen, Tracy E.; Oostema, John; Reeves, Mat; Zammit, Christopher G.; Sabagha, Noor; Sozener, Cemal; Lewandowski, Christopher; Schrock, Jon W. (2019). "The Extended Treatment Window’s Impact on Emergency Systems of Care for Acute Stroke." Academic Emergency Medicine 26(7): 744-751.
dc.identifier.issn1069-6563
dc.identifier.issn1553-2712
dc.identifier.urihttps://hdl.handle.net/2027.42/150496
dc.description.abstractThe window for acute ischemic stroke treatment was previously limited to 4.5 hours for intravenous tissue plasminogen activator and to 6 hours for thrombectomy. Recent studies using advanced imaging selection expand this window for select patients up to 24 hours from last known well. These studies directly affect emergency stroke management, including prehospital triage and emergency department (ED) management of suspected stroke patients. This narrative review summarizes the data expanding the treatment window for ischemic stroke to 24 hours and discusses these implications on stroke systems of care. It analyzes the implications on prehospital protocols to identify and transfer large‐vessel occlusion stroke patients, on issues of distributive justice, and on ED management to provide advanced imaging and access to thrombectomy centers. The creation of high‐performing systems of care to manage acute ischemic stroke patients requires academic emergency physician leadership attentive to the rapidly changing science of stroke care.
dc.publisherWiley Periodicals, Inc.
dc.titleThe Extended Treatment Window’s Impact on Emergency Systems of Care for Acute Stroke
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelMedicine (General)
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/150496/1/acem13698.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/150496/2/acem13698_am.pdf
dc.identifier.doi10.1111/acem.13698
dc.identifier.sourceAcademic Emergency Medicine
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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