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Intro to Stroke Center Designation Criteria

Stroke symptoms – facial droop, one-sided weakness, inability to speak – are fairly easy to recognize with prehospital stroke assessment tools. More and more EMS providers are going to be asked by patient’s family members or caregivers or directed by protocols to transport stroke patients to a designated stroke center.

What does it mean for a hospital to be a designated stroke center?

The American Stroke Association lists four general criteria for a hospital to have an Acute Stroke Treatment Program or what might be commonly called a Stroke Center:

  • Part I: Improve awareness of acute stroke care
  • Part II: Improve availability of optimal stroke care
  • Part III: Implement secondary stroke prevention
  • Part IV: Ensure continuous improvement in stroke outcomes

Part II: Improve availability of optimal stroke care has the most impact on EMS assessment, management, and transport of stroke patients. Specifically a Stroke Center should have these capabilities:

  1. Written stroke protocols
  2. Organized acute stroke team led by a neurologist, neurosurgeon or other qualified healthcare professional
  3. Stroke team lead by qualified physician and nurse (or NP or PA)
  4. Acute stroke team is always available and can be at patient’s bedside in 15 minutes or less
  5. Developed communication pathway between EMS and stroke team
  6. Stroke center assists and/or supports EMS education about stroke at least bi-annually
  7. Neuro-imaging services, like CT scans, are always available and can be performed within 25 minutes of order and scans interpreted within 20 minutes of completion
  8. Stroke unit capable of caring for stroke patients beyond acute treatment period

Does your nearest hospital meet these criteria for a Stroke Center? Do you have a protocol to transport acute stroke patients to Stroke Centers? In which cases should you transport to the nearest hospital instead of a designated stroke center?

Review the F.A.S.T. Stroke Assessment tool.

Extra content: Legislation in Illinois establishes stroke centers.

By Greg Friese

Greg Friese, Stevens Point, Wisconsin, is an author, educator, paramedic, and marathon runner.

Greg was the co-host of the award winning EMSEduCast podcast, the only podcast by and for EMS educators. Greg has written for,, Wilderness Medical Associates, JEMS Magazine, and EMS World Magazine, and the NAEMSE Educator Newsletter.