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A Systems Approach to Immediate Evaluation and Management of Hyperacute Stroke NINDS Stroke Study Group, Stroke 28:1530-15401997., , 1997 See this aricle in Pubmed Article Abstract Phase I of the trial included several months of preparation with review of every detail involved in the process of acute stroke care at each site.All centers worked closely with emergency medical services.Community stroke awareness and education programs were developed.A stroke team was initiated and worked closely with the emergency department physicians and nurses.Rapid and efficient communication systems and protocols were established to reduce time to complete each task.Standardized stroke examinations and protocols for blood pressure management and intracranial hemorrhage detection as well as nursing flowcharts were used.Hyperacute stroke treatment can be initiated,often within 55 minutes of patient arrival at the hospital,in both community and academic settings when all aspects of the stroke care processes are identified,streamlined and built into the day to day operations of the prehospital and hospital health care delivery system.

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