A subject not currently stressed in emergency medicine residency curricula is the natural history of ischemic stroke, and particularly those issues dealing with time-sensitive events in brain ischemia. These include time-critical pathophysiological changes and those events that necessitate an emergency response and early intervention.
Patient identification is a second area that requires more study and better guidelines.
Just as emergency medical services personnel must be able to rapidly assess a stroke patient, so too must ED personnel be trained to rapidly appraise stroke-related events. Information that might seem simple to obtain may not be so. For example, establishing the pivotal time of stroke onset can be very difficult. A third issue regards thrombolysis. Since this is the current treatment for acute ischemic stroke, ED nurses and EPs must clearly understand the inclusion and exclusion criteria for thrombolysis and the potential benefits.