The primary objective of the patient access core is to maintain our current high volume of acute strokepatients treated with intravenous tissue-plasminogen activator (iv tPA) within 2 hours of onset of symptoms.We have developed an efficient and reliable internal system for the triage and treament of patients with acuteischemic stroke, as well as an extensive community network involving both hospitals and emergency medicalsystems (EMS) providers. This effort has been a collaborative process involving physicians and nursesfrom stroke neurology, the emergency department, and radiology, as well as hospital administration andother support staff these departments and the pharmacy. This infrastructure will be utilized to accomplishthe objectives of the patient access core. In addition, we have developed a comprehensive stroke patientregistry, aspects of which will be integrated into the SPOTRIAS network. The Patient Access Core has 4major purposes. The first is to ensure that we treat at least 12 patients with iv tPA per year within 2 hours ofonset of symptoms. This has been and will continue to be accomplished through continuous qualityassurance efforts led by the Emergency Department Acute Stroke Committee, as well as continuingeducational outreach efforts to EMS and referring hospitals and physicians. We have strong preliminarydata that these efforts are necessary. The second purpose is to identify, recruit and enroll patients forprojects 2 and 3. We will train emergency room staff, neurology and emergency department residents toidentify patients eligible for these two protocols. SPOTRIAS research coordinators will recruit and enrollpatients into these studies. The third purpose is to enroll stroke patients into the Cognitive Rehabilitation andRecovery Group (CRRG) database. This is our comprehensive registry of stroke patients seen at ourinstitution. The database has been a valuable resource for preliminary data for the development of researchprotocols, including acute stroke intervention, secondary stroke prevention, and rehabilitation studies. Inaddition it has been used to identify patients eligible for secondary stroke prevention studies and trials ofrehabilitation interventions. The fourth purpose is to collect serum and DMA samples (Core E) from patientsenrolled in the CRRG for storage and possible further analysis by intramural and extramural SPOTRIASinvestigators.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Specialized Center (P50)
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Special Emphasis Panel (ZNS1-SRB-G (24))
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Washington University
Saint Louis
United States
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