BACKGROUND: Stroke is an emergency. In order to provide proper acute stroke treatment, there must be prompt activation of a stroke response system designed to deliver timely and optimum care. In our institution, the Brain Attack Team (BAT) was initiated upon the inception of the neurology residency training program.

OBJECTIVES:to ascertain the number and nature of BAT referral cases; to determine the time frames of the acute stroke response system observed in our institution. The time frames were compared to target times recommended by the National Institute of Neurological Disorders and Stroke (NINDS).

METHOD: We reviewed records of 399 BAT referral cases - both emergency room (ER) and floor referrals -over a ten-month period from January to October 2007. Frequency and percentage distributions were computed for the number of BAT referrals. Median time intervals in minutes were computed.

RESULTS: January had the most number of BAT calls at 17% (68 of 399). Fifty-five percent (220 of 399) of BAT calls were made during the night duty shift. Ischemic strokes had the highest incidence at 49.6% (198 of 399). Fifty-three percent (211 of 399) of patients were able to arrive at the ER within 3 hours; 47% (99 of 211) of these patients were ischemic stroke cases, and therefore eligible for possible thrombolysis. Of the 99 eligible patients, 8 passed our hospital criteria for thrombolysis. Intravenous recombinant tissue-plasminogen activator (rTPA) was administered in 6 out of 8 patients. Median time values were as follows: Ictus-to-Door time was 180 minutes, Door/Ictus at the floors-to-BAT referral was 30 minutes, BAT referral-to-BAT response was 5 minutes, Door/Order-to CT scan was 43 minutes. Door/Ictus at the floors-to-Drug median time among thrombolysed patients was 102.5 minutes.

CONCLUSION: Median time of BAT referral-to-BAT response was immediate. This was true even during night shift. Among those cases of patients who were given thrombolytic therapy, Door/Order-to-CT scan was within the NINDS target.