Hyperacute stroke management is coming … one Mississippi, two Mississippi

In acute stroke, time is brain for both time to thrombolysis2 and time to thrombectomy.3 Quality improvement attempts in stroke management have targeted delays in the hospital. Earlier studies showed that prenotification of the hospital team by emergency medical services, in combination with further restructuring of stroke management processes,4 such as a structured in-hospital alert system, hand-off at the CT scanner, transfer of laboratory test on a point-of-care laboratory system,5 etc., can cut crucial time before therapy and increase thrombolysis rates. Similar efficient protocols have aimed to reduce delay before start of thrombectomy (groin puncture time).