Hyperacute

The Heart and Stroke Foundation of Ontario conducts public awareness campaigns promoting the warning signs and symptoms of stroke using a variety of methods including television ads, print media and local events.

• Stroke Signs and Symptoms: FAST
• What are there other signs?

Paramedic Prompt Card for Acute Stroke Bypass Protocol

• Click here for this Paramedic Prompt Card

Pre-Hospital Los Angeles Motor Scale (LAMS) for Stroke Severity  

Paramedics across Ontario are using the LAMS to help identify possible large vessel occlusion (LVO) stroke and potential eligibility for Endovascular Thrombectomy (EVT).  

• CorHealth Ontario LAMS Educational Video and Presentation for EMS providers:
  •  LAMS Training for EMS Providers
  •  LAMS Self-Training and Education Module
  •  Quiz
•  Southeastern Ontario brief LAMS resources: 
  • Pocket card
  • Poster 

The region has established Acute Stroke Protocols to standardize timely assessment and management of those experiencing a stroke. This includes the paramedic stroke response and emergency department care and management. Acute Stroke Protocols and other resources are listed below. 

Acute Stroke Protocol: KHSC-Kingston General Hospital Site

• KGH ED Poster - Emergency Guide for Thrombolysis and/or Endovascular Thrombectomy (EVT)
• KGH In-Hospital Poster - Internal Activation of the Acute Stroke Protocol
• KHSC-KGH site ACT-FAST Poster - EVT screening tool for patients presenting with stroke symptoms between 6-24 hours
• Rationale Guidelines for the use of Thrombolysis and/or EVT in the treatment of acute ischemic stroke at KGH
• KGH ED Repatriation - Transfer & Discharge Guidelines for Stroke/TIA Patients NOT Requiring Admission at KGH
• Roles and Responsibilities for Thrombolytic Therapy and Endovascular Thrombectomy

Acute Stroke Protocol: KHSC-Hotel Dieu Hospital Site

• Hotel Dieu Hospital Acute Stroke Protocol 

Regional Acute Stroke Protocol - Lennox & Addington County General Hospital/Perth and Smiths Falls District Hospital

• Emergency Transfer Poster - Transfer Guide for patients who may be eligible for treatment at KGH (Thrombolysis and/or EVT)
• Regional Acute Stroke Protocol Repatriation Agreement for facilitating repatriation of patients with stroke between hospitals in Southeastern Ontario 

KGH Endovascular Thrombectomy Transfers: Quinte Health/Brockville General Hospital

• Quinte-KGH Stroke EVT Transfer Algorithm
• Quinte Belleville General Emergency Transfer Guide for EVT 
• Brockville General Hospital Emergency Transfer Guide for EVT

ACT-FAST - Large Vessel Occlusion Screen

The ACT-FAST is a large vessel occlusion screen for EVT being used to guide decision making for triaging patients arriving in the Emergency Department with stroke symptoms between 6-24 hours. 

• South East Community Hospital ACT-FAST Poster
• Provincial ACT-FAST education resource including videos

Regional Acute Stroke Protocol (RASP) Committee

The RASP Committee meets annually and is responsible for advising the region related to the effective implementation and delivery of the Regional and District Acute Stroke Protocols for Southeastern Ontario.

**If you have any questions about the Regional Acute Stroke Protocol or the Regional Acute Stroke Protocol Committee please contact Shelley Huffman, Regional Director, shelley.huffman@kingstonhsc.ca or Kayla Purdon, Regional Stroke Best Practice Coordinator, kayla.purdon@kingstonhsc.ca 

Hyperacute Stroke Treatment focuses on restoring blood flow to the brain. Thrombolysis and or Endovascular Therapy are time-sensitive treatments that can be used in ischemic stroke. 

• Canadian Stroke Best Practice Recommendations for Acute Ischemic Stroke Treatment

Thrombolysis

Thrombolysis treatment is the administration of a clot-busting medication in attempt to dissolve the clot and restore blood flow to the brain. This treatment is available at Kingston General Hospital, Quinte Health and Brockville General Hospital. 

Quinte Health and Brockville General Hospital utilize the Provincial Telestroke system to support the administration of thrombolysis. The below videos from Quinte Health demonstrate how the use of Telestroke can support access to this hyperacute treatment. 

• Quinte Code Stroke Video (Full Version)
• Quinte Code Stroke Video (Short Verion) - emphasis on Paramedic role

Endovascular Therapy

Endovascular Therapy (EVT) is a medical procedure to remove the blood clot from the brain. This treatment is available at Kingston General Hospital

• EVT Family Education Booklet