I recently did a CVA call the family did not call until 4.25 hours after the onset of left sided deficits. We arrived at Civic 4.75 after the onset. To my surprise, a stroke code was called, the pt was whisked off to CT. We were lucky that this pt lived close to the civic, had he lived next to the Montfort, he would not have been transported to the appropriate facility. Pts V/S were unstable, we returned on a code 4, if his v/s had been stable, we could have returned on a code 3. CACC also sends ambulances to CVA calls code 3 if the onset is greater than 3.5 hours. I asked the nurse about this, he told me the civic has expanded the time frame, TPA can be administered up to 4.5 hours and thrombolectomy can be performed up to 6 hours after the onset. I advised OPS about this, they said they would look into it. Why are stroke pts slipping through the cracks being transported to the wrong hosp and wrong return code? We need to be on board with the new CVA guidelines. Thanks
Thank you for your submission. The current MOHLTC EHSB provincial standard of the Stroke by-pass is the protocol to follow. In light of your question, Dr. Dionne will be bringing this topic to the MAC for discussion.