Regional Stroke Triage Plan Update

From Lori Knowles, Heart and Stroke Committee Chair:

A number of updates to the Regional Stroke Plan were recently approved by the Heart and Stroke Committee and the Rappahannock EMS Council’s Board of Directors.

The new version is available on the REMS website, and all REMS Social Media accounts.

The 2017 changes include:

  • The Virginia State Stroke Task Force recently recommended changes to stroke care in the Commonwealth. The Virginia Office of EMS State Stroke Plan was subsequently updated and approved by Governor’s EMS Advisory Board in August, 2017. These changes are reflected in REMS Regional Stroke Plan.
  • An updated Field Stroke Triage Algorithm for EMS has been incorporated.
  • A Large Vessel Occlusion (LVO) screening tool for EMS providers has been added. REMS has chosen to use the VAN (Visual, Aphasia, Neglect) Stroke Scale as the screening tool within our region, which will be performed following a positive CPPS(Cincinnati Pre-Hospital Stroke Scale)/FAST(Face, Arm, Speech, Time) screening.
  • The plan has placed emphasis on ‘Wake Up Stroke”. Wake up stroke is defined as awakening with stroke symptoms that were not present prior to falling asleep. Roughly 1 in 5 acute strokes are Wake-up strokes. MRI imaging is done on these patients to help determine when the stroke occurred and whether the patient is a candidate for intervention despite the last seen well time being outside the treatment window.
  • AHA Mission Lifeline Severity-Based Stroke Triage Algorithm for EMS utilized for revised Regional Stroke Plan and Protocol as evidenced based practice.

Please feel free to contact the Council at or 540-373-0249 with any questions you may have.

REMS Regional Stroke Plan 2017-10

View Original Memo Here

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