Evidence-based Clinical Care: Identification and Treatment of Acute Ischemic Stroke or Transitory Ischemic Attack

Stroke is a very common and disabling condition. It is critical to promptly identify patients and start them on a treatment pathway that will yield the best patient outcomes. Selecting potential candidates for reperfusion therapies (tPA / alteplase and thrombectomy / NIVR) within 24 hours of stroke symptom onset is paramount. This course will provide learners with the latest evidence-based data supporting patient selection and treatment pathways for acute ischemic stroke and transitory ischemic attack (TIA). These pathways are part of the evidence-based clinical care standardization efforts streamlining care throughout Baptist Health facilities.

Evidence-based Clinical Care (EBCC) Note: Physicians should bookmark this course to access all protocols, pathways, policies and procedures at your convenience via your CME Portal account. All algorithms will be available on CERNER. 

Target Audience

Neurologists, Neurosurgeons, Neurointensivists, Neuroradiologists, Radiologists, Geriatric Medicine Physicians, Internal Medicine Physicians, Intensivists, Emergency Medicine Physicians, Hospitalists,  Physician Assistants, Stroke Educators involved with the care of acute ischemic stroke patients.

Learning Objectives

  • Implement standards of care and recognize the need for creating a clinical pathway for stroke and transient ischemic attack (TIA) based on current, evidence-based best practices.
  • Identify patients with acute ischemic stroke and those eligible for reperfusion therapies.
  • Improve confidence and appropriateness of stroke alert activation.
  • Utilize the new eligibility criteria for tPA and endovascular thrombectomy in the updated AHA/ASA guidelines for the management of acute ischemic stroke.
  • Adopt imaging modality protocols to quickly identify stroke and begin early treatment.
  • Appropriately follow the Baptist Health South Florida power plans available for the management of acute ischemic stroke and transitory ischemic attack.
  • Recognize the metrics that will be evaluated and monitored through the Leidos/CareC2 platform to ensure that standardization is successfully implemented.
Additional information
Bibliography: 
  • Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 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 2018;49:e46-e110.
  •  Kernan WN et al. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack, A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, Journal of the American Heart Association. July 2014.
Resources: 

How to save power plans (EBCC order sets) to your favorites on CERNER? Click here to access video tutorial.​

Course summary
Available credit: 
  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 General certificate of attendance
Course opens: 
04/01/2018
Course expires: 
10/31/2021
Rating: 
0

Felipe de Los Rios de la Rosa, M.D.
Medical Director, Baptist Hospital Comprehensive Stroke Center & Baptist Health South Florida Stroke Program
Voluntary Assistant Professor of Neurology
University of Cincinnati Department of Neurology & Rehabilitation Medicine
Florida International University Herbert Wertheim College of Medicine
Miami, Florida

Felipe De Los Rios, M.D., indicated that neither he nor his spouse/partner has relevant financial relationships with commercial interest companies, and he will not include off-label or unapproved product usage in his presentation or discussion. 

Italo Linfante, M.D., has indicated that he is a consultant for Medtronic and Stryker and a shareholder  in InNeuro Company and Three Rivers.

Kevin J. Abrams, M.D., has indicated that he is a consultant for Keystone Heart.

Guilherme Dabus, M.D., has indicated that he is a consultant/speaker for Medtronic, Penumbra and Microvention and a shareholder in Surpass/Stryker, Medtronic/Medina Elum, Three Rivers and InNeuro Company.

All other evidence-based clinical care committee design team members and those involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
             
Baptist Health South Florida designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 0.75 AMA PRA Category 1 Credit™
  • 0.75 General certificate of attendance
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