For “time is the brain”, what can be done prehospital

Acute ischemic stroke, which is one of the leading causes of death or permanent disability, can be treated with intravenous recombinant tissue plasminogen activator (tPA) within 4.5 h or intraarterial treatment (IAT) within 8 h. Time from symptom onset to initiation of treatment has a close relationship with the good outcome. But in actual clinical practice, it is difficult to ensure that acute ischemic stroke (AIS) patients can get treatment within the time window. To reduce the delay, many methods have been established for fast prehospital treatment, including stroke public awareness, treatment of emergency medical services, patient information transmission, and mobile stroke unit (MSU). Stroke educational campaigns are promoted to improve the patients and relatives’ awareness of the correct response to the stroke. When the stroke occurs, the role of emergency medical services (EMS) can be reflected. Telemedicine interaction between the two hospitals has a positive impact on thrombolysis rates and clinical outcomes. According to the MSU used, shorter time needed to treatment, and increased proportion of patients treated within the time window. In this review, we describe the importance of time for acute stroke therapy, analyze the possible causes of time delay, present the main methods of saving time in the clinic, and analyze the problems of these methods.