Guidance for Stroke Centers Aiding COVID-19 Treatment Teams

Jul 01, 2020   |  Mollie McDermott, MD, MS
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Authors:
Wira CR, Goyal M, Southerland AM, et al., on behalf of the AHA/ASA Stroke Council Science Subcommittees: Emergency Neurovascular Care (ENCC), Telestroke and the Neurovascular Intervention Committees; and on behalf of the Stroke Nursing Science Subcommittee of the AHA/ASA Cardiovascular and Stroke Nursing Council.
Citation:
Pandemic Guidance for Stroke Centers Aiding COVID-19 Treatment Teams. Stroke 2020;Jun 23:[Epub ahead of print].

The following are key points to remember from this review on pandemic guidance for stroke centers aiding coronavirus disease 2019 (COVID-19) treatment teams:

  1. During the ongoing COVID-19 pandemic, stroke centers may be asked to support their health systems by devoting resources or staff to assist COVID treatment teams.
  2. Stroke center providers including nurses, advanced practice providers, vascular neurologists, neuro-hospitalists, and neurointensivists should be prepared to manage COVID patients in their home units. These patients may have a primary neurologic diagnosis with concomitant COVID or may be COVID overflow patients from units with no additional capacity.
  3. Stroke center providers should also be prepared to manage COVID patients in non-neurology or neurosurgical units (“redeployment”).
  4. Health systems should provide education, training, and centralized clinical guidance/protocols for all providers working with COVID patients, especially for those providers practicing outside of their usual scope of practice.
  5. When determining provider redeployment, stroke center directors should ensure adequate coverage for acute stroke care and stroke unit care. There should always be at least one vascular neurologist and one backup provider available in case of staff drop-out for exposure or illness, with adequate time for quarantining between in-house rotations.
  6. If needed, neurohospitalists and vascular neurologists can manage a non-neurology treatment team caring for noncritically ill patients with COVID.
  7. Stroke centers often have robust research infrastructure, which can be redeployed to rapidly launch or support new COVID registries or treatment trials.
  8. Because stroke centers often have established lines of communication and overlapping care responsibilities (e.g., transfer agreements) with outside institutions, stroke centers can serve to help other health systems with strained capacities or significantly high staff attrition due to COVID.
  9. Telestroke technology platforms can be utilized by other specialties (e.g., pulmonology) wishing to perform remote consults in the emergency room or other units during the pandemic.

Clinical Topics: COVID-19 Hub, Prevention

Keywords: Coronavirus, COVID-19, Emergency Service, Hospital, Neurology, Pandemics, Primary Prevention, Pulmonary Medicine, severe acute respiratory syndrome coronavirus 2, Stroke, Vascular Diseases


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