Acute Cerebral Vascular Syndrome (ACVS) Care

In 2008, the Canadian Best Practice Recommendations for Stroke Care stated that all patients with acute stroke should undergo immediate brain imaging (a CT scan), and eligible patients should be treated with tPA (a clot busting drug).

To meet these recommendations, the BC Stroke Strategy Provincial Stroke Action Plan recommends significantly expanding and re-engineering the delivery model for stroke in BC:

• Confirm hospital/facility functional capacity and role designation with respect to stroke care capacity across the province; and
• Ensure timely assessment of patient needs and expedited transport to the most appropriate facility through a coordinated pre-hospital assessment and triage system.

The plan was tabled with the BC Ministry of Health Services and regional Health Authorities in December 2010 for decision around governance, funding and implementation.

 

Stroke Education

The development of best practices at the national and provincial levels and the creation of the BC Provincial Stroke Action Plan has revitalized the need for a more organized, centralized and comprehensive approach to stroke education for health care providers. Click here for the Professional Educational Atlas, a summary of educational initiatives available across Canada and health regions in BC. Please note that links to on-line resources and reference materials must be copied and pasted into your web browser.

 

Stroke education for nurses has been identified as one of the major gaps in realizing best practice in stroke care within BC. To gain a better understanding of this issue and to provide recommendations in the development of a provincial stroke action plan, the BC Stroke Strategy conducted an educational needs assessment in June and July 2010. Click here for the results of the survey and the report's recommendations.

 

Consensus Statements

At the request of the BC Ministry of Health Services, a medical consensus statement has been developed and formally released. Providing Optimal Stroke/Acute Cerebral Vascular Syndrome Care in BC: A Clinical Leadership Consensus Statement outlines the four key components necessary to provide optimal stroke/ACVS care, including defining what pre-hospital and acute hospital care should be available. This document provided the clinical basis for designating levels of stroke care in the province. It is a core component of the Provincial and Regional Stroke Action Plans.

In addition, a formal clinical consensus statement has been developed by the BC Section of Emergency Medicine: Position Statement: Emergency Physician Thrombolysis for Acute Stroke, January 2009. This supports Emergency Department physicians in administering the clot busting drug tPA. The Emergency Medicine Section of the BC Medical Association has endorsed the statement, and circulated it to physicians in emergency departments across British Columbia.