Leaving A Legacy Of Stroke In Europe: A Community Of Dedicated Professionals Is Changing The Face Of Stroke In Europe

Author:Robert Mikulik, Pauli Ylikotila, Risto Roine, Miroslav Brozman, Sandy Middleton
Volume Info:Volume 3 Issue 1
Article Information

Volume 3 Issue 1 , pages 8-18
Received – 22 June 2017, Accepted – 26 June 2017


Department of Neurology & International Clinical Research Center, St. Anne’s University

Hospital and Masaryk University, Brno, Czech Republic.


Division of Clinical Neurosciences, Turku University Hospital,Turku, Finland


Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Finland


Department of Neurology, Faculty Hospital Nitra, Constantine Philosopher University Nitra, Slovakia


Director, Nursing Research Institute, St Vincent’s Hospital, Sydney, Australia


Corresponding Author: Robert Mikulik – robert.mikulik@fnusa.cz


Time is of the essence in the treatment of acute stroke; however, there are wide variations, across and within countries, in the ability to hospitalize, scan, diagnose, and treat acute stroke patients rapidly within the accepted time window of 4.5 hours. Door-to-needle (DTN) time is an important performance indicator that illustrates the speed and operational efficiency of stoke units. Significant progress is being made; DTNs often exceeded an hour only a few years ago, but can now be achieved in under seven minutes in leading stroke units. This symposium examined the strategies and contributory factors that result in reduced DTN times, and how these strategies can be more widely implemented. The Quality in Acute Stroke Care (QASC) programme in Australia has shown the incorporation of standardized nurse-led treatment protocols for the management of fever, hyperglycaemia, and dysphagia (FeSS protocols) significantly improve outcomes for stroke patients. European evaluation of these protocols, in collaboration with ESO and the ANGELS initiative, and potentially leading to their adoption in European acute stroke treatment practice is discussed.

Acknowledgements: The editorial assistance of Mr Rob Goodwin, Oruen Ltd, in the preparation of this article is acknowledged with thanks.


acute stroke, door-to-needle, FeSS protocols, QASC



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