World-Stroke

Appendix One: Content Areas for Stroke Guidelines

The following table provides a list of the recommended core content to be addressed in any guidelines covering specific components of the continuum of stroke care. Additional content can also be included to address local goals and priorities. These content areas were identified by consensus and based on a content review and analysis of current stroke research literature and existing stroke guidelines.

Ischemic Stroke and Transient Ischemic Attack:

Component of Stroke Continuum	Core Content Areas to be Considered in Related Stroke Guidelines
Stroke System Organization	Systems of stroke care EMS bypass protocols Services for TIA and minor stroke Interprofessional stroke teams Transition management
Primary Prevention & Health Promotion	Community education about stroke Public awareness of the signs and symptoms of stroke Healthy lifestyle: diet, exercise, weight, sodium Blood pressure Smoking cessation
Patient and Family Care and Education	Patient and family education Caregiver burden and strain
Hyperacute Stroke Care – Out-of-hospital and Emergency Department	Emergency medical services assessment and management out-of-hospital Neurovascular imaging Blood glucose Acute thrombolysis Acute aspirin therapy
Acute Stroke Management	Stroke units Dysphagia Early mobilization Venous thrombosis prophylaxis Temperature/fever management Continence
Rehabilitation	Early rehabilitation assessment Access to rehabilitation Stroke rehabilitation units Components of inpatient and outpatient stroke rehabilitation Depression post stroke Vascular cognitive impairment Shoulder pain Therapy for hemiplegic upper/lower limb
Secondary Stroke Prevention	Management of minor stroke and transient ischemic attack Lifestyle management Blood pressure Lipid management Diabetes Antithrombotic therapy Anticoagulation for atrial fibrillation Carotid intervention
Community Reintegration and Long Term Recovery	Transition planning Primary care follow-up and coordination of ongoing medical services Outpatient rehabilitation and exercise programs Social reengagement, resuming activities of daily living, vocations Support services in the community (peer support, home support, psychosocial support) Safety and home modifications Support for ongoing communicative impairments Ongoing information and education, especially related to adapting to new roles

Hemorrhagic Stroke:

Component of Stroke Continuum	Core Content Areas to be Considered in Related Stroke Guidelines
Stroke System Organization	Systems of stroke care EMS bypass protocols Services for TIA and minor stroke Interprofessional stroke teams Transition management
Primary Prevention & Health Promotion	Public awareness of the signs and symptoms of stroke Healthy lifestyle: diet, exercise, weight, sodium Blood pressure Smoking cessation
Patient and Family Care and Education	Patient and family education Caregiver burden and strain
Hyperacute Stroke Care – Out-of-hospital and Emergency Department	Emergency medical services management out-of-hospital Neurovascular imaging Surgical assessment Blood pressure management Glucose management
Acute Stroke Management	Medical therapy Stroke unit/intensive care monitoring Post-surgical care
Rehabilitation	Early rehabilitation assessment Access to rehabilitation Stroke rehabilitation units Components of inpatient and outpatient stroke rehabilitation Depression post stroke Vascular cognitive impairment
Secondary Stroke Prevention	Blood pressure management Diabetes management Smoking cessation Alcohol Management
Community Reintegration and Long Term Recovery	Transition planning Primary care follow-up and coordination of ongoing medical services Outpatient rehabilitation and exercise programs Social reengagement, resuming activities of daily living, vocations Support services in the community (peer support, home support, psychosocial support) Safety and home modifications Support for ongoing communicative impairments Ongoing information and education, especially related to adapting to new roles