The senior clinician responsible for Vera reviews her eligibility for thrombectomy. They confirm that Vera was previously independent, has a definite new ischaemic stroke with deficits severe enough to warrant thrombectomy and a large artery occlusion on the CTA. (See Eligibility for thrombectomy Word .doc)
The stroke physician phones the regional thrombectomy hub to discuss Vera with the hub stroke physician who reviews the CT/CTA on the national picture archiving and communication system (PACS) and agrees thrombectomy likely to be beneficial. He talks with an interventionalist who carries out thrombectomies (most likely Interventional Neuroradiologist (INR) or Interventional Radiologist (IR) but might be from another specialty such as cardiology). The interventionalist agrees that thrombectomy is indicated and possible.
The two stroke physicians and the interventionalist share direct phone details to facilitate further communication between them.
The spoke team phone the SAS using the number agreed locally. Each region has a list of the numbers they should call supplied by SAS.
The SAS team estimate a 60 min drive time and immediately dispatch an emergency ambulance – in this case an air ambulance is not necessary. Please note that SAS will make the judgement on the most appropriate mode of transport.
NB: in some places the spoke consultant is asked to contact the INR/IR directly rather than going via the stroke physician. So please refer to your local pathway.
