During the COVID-19 pandemic, it is more important than ever to ensure that a patient with stroke is transferred to the right hospital the first time around.
Mayank Goyal, MD
Recommendations created by an international group of stroke specialists, on behalf of the American Heart Association (AHA) and American Stroke Association (ASA) Stroke Council Science Subcommittees, have been published, seeking to minimize the risk of infectious exposure of COVID-19 for emergency medical service (EMS) providers when transferring patients with acute stroke.1
While the COVID-19 pandemic has broad implications on stroke patient triage, there are still unanswered questions and protocols to follow to minimize safety concerns. The recommendations note that EMS providers need to access a patient with acute stroke’s history and neurological status and determine the likelihood of a large vessel occlusion (LVO), all in a safe manner. Controlling infectious disease and determining the likelihood of the need for intensive care due to a potential COVID-19 infection are 2 additional factors that have come into play during this pandemic.
The authors, led by Mayank Goyal, MD, clinical professor, department of radiology, University of Calgary, and colleagues, laid the conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future with challenges, resolutions to those challenges, and other take-home points.
The proposed challenges and their resolutions included:
“The principles presented in this statement paper are intended as suggestions rather than strict rules and might serve as a framework to establish and optimize local protocols. As this conceptual framework is preliminary in nature, it will require adaptation to the ongoing COVID-19 crisis and future pandemics,” Goyal and colleagues concluded.
These recommendations come on the heels of another stroke-care guidance published earlier in May 2020, which highlighted the possible issues and their solutions regarding stroke care amid the COVID-19 pandemic. The authors offered advice and specifically addressed the potential impact of the pandemic on the quality of care, ethical considerations, safety and logistic issues, and research in stroke.2
1. Goyal M, Ospel JM, Southerland AM, et al. Prehospital triage of acute stroke patients during the COVID-19 pandemic. Stroke. Published online May 13, 2020. doi: 10.1161/STROKEAHA.120.030340
2. Leira EC, Russman AN, Biller J, et al. Preserving stroke care during the COVID-19 pandemic: Potential issues and solutions. Neurology. Published online May 8, 2020, doi: 10.1212/WNL.0000000000009713