Stroke Systems of Care

Recent randomized controlled trials of stroke thrombectomy have led the American Heart Association to provide recommendations that thrombectomy be pursued in patients with large vessel occlusions who meet certain criteria. Evolving recommendations allow the Brain Attack Coalition to establish, update, and maintain a hierarchal system of care involving the proper management of different types of acute stroke. This chapter will outline various stroke systems of care and assist emergency medicine providers in evaluating, managing, and triaging patients with different types of stroke. The history behind the development of stroke centers as well as the qualifications for each level of care are discussed here alongside example cases of patients best managed at the various hospital subtypes.