Stroke patients: follow regional stroke system protocols where available; otherwise transport to which center?

• A. closest Level I stroke center
• B. closest Level II stroke center
• C. closest Level I, II or III stroke center
• D. Any hospital with CT

Answer: (C)

Stroke care emphasizes getting the patient to a facility equipped for acute stroke evaluation and treatment as quickly as possible. When regional stroke system protocols exist, follow them to send the patient to the designated center. If no such protocol is available, transport to the nearest recognized stroke center at any level (Level I, II, or III). These centers have the necessary imaging, rapidly coordinated stroke care, and treatment pathways or transfer plans. Hospitals with only a CT scanner may lack 24/7 stroke protocols and the immediate, comprehensive stroke care needed, so they aren’t the default target. Therefore, going to the closest Level I, II, or III stroke center minimizes time to definitive treatment.