Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association

Edward C. Jauch, Jeffrey L. Saver, Harold P. Adams, Askiel Bruno, J. J.Buddy Connors, Bart M. Demaerschalk, Pooja Khatri, Paul W. McMullan, Adnan I. Qureshi, Kenneth Rosenfield, Phillip A. Scott, Debbie R. Summers, David Z. Wang, Max Wintermark, Howard Yonas

Research output: Contribution to journalArticle

2973 Scopus citations

Abstract

Background and Purpose-The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Methods-Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. Results-The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. Conclusions-Because many of the recommendations are based on limited data, additional research on treatment of acute ischemic stroke remains urgently needed.

Original languageEnglish (US)
Pages (from-to)870-947
Number of pages78
JournalStroke
Volume44
Issue number3
DOIs
StatePublished - Mar 1 2013

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Keywords

  • AHA Scientific Statements
  • Acute cerebral infarction
  • Emergency medical services
  • Reperfusion
  • Stroke
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Jauch, E. C., Saver, J. L., Adams, H. P., Bruno, A., Connors, J. J. B., Demaerschalk, B. M., Khatri, P., McMullan, P. W., Qureshi, A. I., Rosenfield, K., Scott, P. A., Summers, D. R., Wang, D. Z., Wintermark, M., & Yonas, H. (2013). Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947. https://doi.org/10.1161/STR.0b013e318284056a