Lack of public knowledge about stroke symptoms and that stroke is an emergency is an important cause of delays in people getting emergency stroke care. Once in the hospital, there are large variations across Europe in how quickly people are treated by stroke specialists. This section looks at what efforts are being made to avoid delays in people getting specialist treatment.
The quicker stroke treatment can be started the better – the concept “time is brain” encapsulates the fact that stroke should be treated as a medical emergency in order to improve outcomes and avoid deaths from stroke.
Minimising the time between the onset of a stroke and treatment involves many people:
〉a person having a stroke (or someone with them) needs to recognise the symptoms and call an ambulance;
〉paramedics need to screen for stroke and take the person directly to the best place for specialist stroke treatment;
〉hospitals need to have clinical pathways that minimise delay (immediate access to CT scanning, for example).
Avoidable delays have been identified at all of these levels across several European countries, including those with highly organised stroke services (Germany, Greece, Italy, Finland). These delays are an important reason for thrombolysis still being under- performed in most of Europe[185-187].