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(Circulation. 2005;112:IV-111 – IV-120.)
© 2005 American Heart Association, Inc.

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Part 9: Adult Stroke

	Introduction

 
Each year in the United States about 700 000 people of all ages suffer a new or repeat stroke. Approximately 158 000 of these people will die, making stroke the third leading cause of death in the United States.^1,2 Many advances have been made in stroke prevention, treatment, and rehabilitation.^3,4 For example, fibrinolytic therapy can limit the extent of neurologic damage from stroke and improve outcome, but the time available for treatment is limited.^5,6 Healthcare providers, hospitals, and communities must develop systems to increase the efficiency and effectiveness of stroke care.³ The "7 D’s of Stroke Care"—detection, dispatch, delivery, door (arrival and urgent triage in the emergency department [ED]), data, decision, and drug administration—highlight the major steps in diagnosis and treatment and the key points at which delays can occur.^7,8

This chapter summarizes the management of acute stroke in the adult patient. It summarizes out-of-hospital care through the first hours of therapy. For additional information about the management of acute ischemic stroke, see the AHA/American Stroke Association (ASA) guidelines for the management of acute ischemic stroke.^9,10

	Management Goals

 
The goal of stroke care is to minimize brain injury and maximize patient recovery. The AHA and ASA developed a community-oriented "Stroke Chain of Survival" that links actions to be taken by patients, family members, and healthcare providers to maximize stroke recovery. These links are

• Rapid recognition and reaction to stroke warning signs
  
• Rapid emergency medical services (EMS) dispatch
  
• Rapid EMS system transport and hospital prenotification
  
• Rapid diagnosis and treatment in the hospital
  

The . . . [Full Text of this Article]

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