Stroke Awareness Month: Ensuring Timely Stroke Treatment

May 21

“When it comes to spotting stroke and getting help, the faster, the better.” - The American Heart Association

Providers need a variety of imaging methods to support accurate and timely diagnosis and treatment; this is particularly important in situations like stroke identification, where every minute counts.

While one type of imaging might be the right choice most of the time, there are cases in which a patient’s care needs require an alternate type of imaging. For example, for some patients who have had a stroke, a CT with contrast can be necessary to look for blockages in the major arteries providing blood to the brain. But not all patients can tolerate contrast (such as patients with renal failure, thyroid disease, or who are pregnant).

Especially with stroke, it’s essential to be prepared to quickly deploy other imaging methods. Every imaging team that may be necessary to support urgent diagnostic and treatment needs should be included in an organization’s stroke protocols.

Opportunity: Strengthening Stroke Protocols

In a recent report to the Patient Safety Reporting Program (PSRP), a facility identified an opportunity to strengthen their stroke protocol for patients who cannot tolerate a CT with contrast. In this report, a patient presented to the ED with symptoms of stroke, and the provider needed to determine if any of the arteries providing blood to the brain were blocked. Contrast was not appropriate for the patient due to their medical conditions, and the provider required imaging with higher sensitivity and accuracy than non-contrast CT, so an MRI was ordered. However, the stroke team was unable to get an urgent MRI because the expectation to expedite a stroke patient had not been set with the MRI team, who were following their policies. Although the delay in care in this case did not ultimately result in harm to the patient, there was potential for a more serious outcome.

What You Can Do

Review your stoke protocols and include plans, like expedited MRI, for patients who can’t tolerate contrast.
Look for other opportunities to include a back-up plan for patients who may have an urgent need for an MRI or similar imaging methods. Communication is key!