ASA Updates Comprehensive Stroke Systems of Care

With the implementation of new innovations and improvements in stroke systems of care over the past decade, the American Stroke Association (ASA) has released a policy statement that includes recommendations for how to best optimize those advancements when treating and caring for patients with acute stroke.1 

One recommendation the authors made in order to achieve a comprehensive stroke system of care and thus improve patient outcomes is that, when an individual is suspected to have had a severe stroke, emergency medical services (EMS) should consider traveling up to an additional 15 minutes to reach a hospital whose staff can perform endovascular thrombectomy.2


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The authors also address the racial discrepancies tied to the use of EMS. According to the statement, minorities—especially those who are black or Hispanic—are less likely to use EMS and are also less aware of the causes and symptoms of stroke.

To ensure all individuals receive timely stroke care, the authors recommend that public health leaders and medical professionals implement public education programs focused on stroke systems and the need to seek emergency care. These programs should especially target at-risk populations.

The ASA statement also includes the recommendation for EMS leaders, governmental agencies, medical authorities, and local experts to adopt consistent, standardized triage protocols so that individuals with a known or suspected stroke can be quickly identified.

In addition, in terms of secondary prevention, the authors write that certified stroke centers should help stroke survivors reduce the of risk of subsequent strokes and that, in terms of rehabilitation and support, a stroke system should provide comprehensive post-stroke care.

“We have seen monumental advancements in acute stroke care over the past 14 years, and our concept of a comprehensive stroke system of care has evolved as a result,” said Opeolu Adeoye, MD, the chair of the writing group for the statement and associate professor of emergency medicine and neurosurgery at the University of Cincinnati, in a press release. “These recommendations reflect how far we have progressed and what still needs to be accomplished to maximize patient outcomes in acute stroke care.”2

—Colleen Murphy


1. Adeoye O, Nyström KV, Yavagal DR, et al. Recommendations for the establishment of stroke systems of care: a 2019 update: a policy statement from the American Stroke Association [published online May 20, 2019]. Stroke.

2. New recommendations for stroke systems of care to improve patient outcomes [press release]. Dallas, TX: American Stroke Association; May 20, 2019. Accessed May 20, 2019.