LAC 48:I.19301. LERN Destination Protocol: Stroke

A. On November 21, 2013, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and (3)] adopted and promulgated "LERN Destination Protocol: STROKE," as follows. 1. The following protocol applies to patients with suspected stroke. Compromise Of: Airway Breathing Circulation | Closest ED NO All other patients with suspected stroke Patients with seizure with focal deficit, extended window (4-8 hrs from onset), and patients with unknown onset may benefit from evaluation at Level I or II hospital with on-site stroke expertise. | Transport to LERN Stroke Level I, II, or III NO Terminally Ill or Palliative Care Patient | Transport to LERN Stroke Level I, II, III, or IV Guiding principles: Time is the critical variable in acute stroke care. Protocols that include pre-hospital notification while en route by EMS should be used for patients with suspected acute stroke to facilitate primary destination efficiency. Treatment with intravenous tPA is the only FDA approved acute therapy for stroke. EMS should identify the geographically closest facility capable of providing tPA treatment. Transfer patient to the nearest hospital equipped to provide tPA treatment. Secondary transfer to facilities equipped to provide tertiary care and interventional treatments should not prevent administration of tPA to appropriate patients. B. This protocol was published at LR 40:189-190 (January 20, 2014).