Prehospital care of the stroke patient.

Acute stroke care is a multidisciplinary effort. It crosses the boundaries of traditional hospital-based medicine, relying heavily on prehospital providers to obtain a significant amount of clinical information. Currently, modifications of existing EMS systems are underway to support the idea that "time is brain." Dispatchers and EMS providers are vital players in the Chain of Recovery, and are challenged to perform within this new paradigm for acute stroke care. In the near future, optimal management of the acute stroke patient may include the administration of neuroprotective medications in the prehospital setting. Educational efforts targeting high risk and elderly populations also continue to be a priority for healthcare providers and public interest groups such as the NSA. Stroke victims, family members, and caregivers must all be aware of the warning signs and symptoms of stroke. The importance of using EMS during the initial phase of acute stroke cannot be overstated. Emergency physicians must lead in coordinating the resources, placing greater emphasis on educating and assessing the performance of prehospital providers [50]. These leaders must ensure that prehospital providers understand they are integral members of the stroke team, vital to improving stroke care in the community.