Trend: Moving stroke victims to best, not closest hospital

Increasingly, paramedics are bypassing closer hospitals and taking potential stroke victims to the closest hospital with specialized expertise in stroke management. This approach is also becoming more common when it comes to patients with heart attacks, who are being shuttled, in some big cities, to hospitals with special cardiac teams. Making this kind of trip is already common when treating severely injured victims of accidents or violence, who are typically taken to hospitals with trauma centers rather than the closest facility at hand, and advocates of routing patients to cardiac or stroke specialty centers say patients get similar benefits. The idea is that in each of these cases, specialist staffs can move more quickly and perform better, making up for any time lost on the road.

At present, there's some debate as to whether this approach is necessary. Some specialists suggest that only a small fraction of patients with strokes, for example, can benefit from the highly specialized expertise of a stroke center, and might have done just as well at a smaller community hospital. Meanwhile, others point to research like the 2006 study in the journal Neurology, which found that when New York paramedics take patients to stroke centers, the staff delivered care faster than at hospitals not designated as stroke centers. Other studies have shown that stroke centers treating more than 100 cases a year had fewer adverse events.

To learn more about this trend:
- read this USA Today piece

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