Prehospital stroke treatmment in the aspect of thrombolytic therapy

Introduction. Stroke is a major medical, economic and social problem. Thrombolytic therapy is the only form of stroke treatment which is truly effective. This therapy is applied too rarely in patients with ischaemic stroke. Aim. To present prehospital stroke treatment procedures, from recognizing the symptoms by the patient or his relatives at home to hospital admission, considering local circumstances in the Department of Neurology with Stroke Unit in the hospital in Działdowo. Discussion. Medical procedures in the prehospital period are based on the so-called chain of survival for stroke patients. The chain of survival consists of five elements. The first element is the recognition of the symptoms and providing first aid on the spot by witnesses and the medical staff. The second step is correct emergency communication, next obtaining qualified prehospital aid, then specialist transport by a resuscitation ambulance, and finally – treatment in a hospital emergency unit or admission room performed by stroke unit staff. Every element – every stage of the treatment must be of the highest quality and must be performed within the shortest possible time. Undertaking thrombolytic therapy is only possible within 3–4.5 hours after the first symptoms. Disqualification from thrombolytic therapy may result from a delayed recognition of stroke by the patient and his family, calling for medical help too late, and a delayed arrival to a specialized stroke centre which can provide alteplasis. Conclusions. Prehospital procedures based on the chain of survival for stroke patients are of fundamental significance to enable undertaking thrombolytic therapy of ischaemic stroke (rt-Pa, recombined tissue plasminogenactivator), the only specific method of treatment so far. Educating the society as concerns stroke and training professionals involved in stroke treatment can increase the percentage of patients treated with rt-Pa.