CT Stroke Code Dramatically Reduces Door-to-needle and Door-to-groin Times for Reperfusion Therapy.

Background and aim: Shortening door-to-needle (DTN) time is one of the major goals of reperfusion therapy. Several strategies have been proposed to shortening DTN including fast track emergency room (ER) protocols, and tPA administration in the CT suit. A comprehensive Stroke Code (SC) pre-notification leading to a direct transfer of patients to the CT suit, bypassing ER, may dramatically reduce DNT. To ensure quality of care, and continuity of care in this process, the role of an expert stroke nurse may also be essential. We aimed to assess the impact of SC and direct transfer to CT (CT-SC) on DTN and door-to-groin (DTG) time and to evaluate the role of an expert stroke nurse to ensures the continuity of patient′s care from admission. Methods: Forty-four CT-SC patients were compared to 81 contemporary SC patients who underwent reperfusion treatment first evaluated at ER. Once CT-SC was activated, and information provided was clear, patient was directly transfer from ambulance to CT. An expert stroke unit nurse wait for the patient in the CT suit. If SC was not activated, patient unstable or information was incomplete or unclear, the patient was first transfer to the ER before CT. Clinical data and response times were evaluated. The primary outcome was the reduction of DTN time to Results: In the CT-SC group 52.2% patients were treated in Conclusions: CT-SC protocol markedly reduces DTN and DTG times, increasing the number of patients treated bellow