Stroke emergency care system of a community medicine cooperating with public administration

Abstract

To evaluate the role of a comprehensive stroke center in community medicine, the achievements of a stroke emergency care system at our institute and the Yokohama City Bureau were reviewed. The Yokohama-shi Cerebrovascular Disease Emergency Care System was developed in 2008 in cooperation with the City Medical Bureau, emergency services, and thirty participating medical institutions. This system specialized in stroke care and treated the patients suspected of having acute stroke based on assessments made by emergency services. After being transferred to participating hospitals, 3-400 patients in the whole city area per year were diagnosed as having an acute brain infarct and were treated with alteplase for thrombolysis. From April 2016 to March 2017, our institute treated 22 patients with thrombolysis out of 127 hospitalized stroke patients through stroke hot line from emergency service. Our stroke hot line is connected to the Yokohama-shi Cerebro-vascular Disease Emergency Care System and is clinically informative, particularly for intensive therapy of acute brain infarcts. However, many non-stroke patients have been encountered through the stroke hot line, and some true stroke patients have conditions mimicking general emergency diseases. To avoid clinical errors which are pitfall so-called, neuro-emergency specialists must have a broad unbiased diagnostic perspective.