Emergency department evaluation and management of stroke: acute assessment, stroke teams and care pathways.

The emergency department (ED) is the entry point into the health care system for many stroke victims. Rapid evaluation, diagnosis and treatment of stroke in the prehospital setting as well as the ED are integral to preventing morbidity and mortality. In some centers, emergency medicine physicians are the health care professionals most often able to provide thrombolytic therapy to stroke patients during the brief three-hour window for this therapy. An organized ED approach including implementing stroke care pathways and collaborating with specialized stroke teams in the ED enhance the ability to identify and manage stroke patients effectively. This approach has the potential to improve outcomes on a large scale.

Status report: Development of emergency medicine research since the Macy Report.

In Williamsburg, VA, April 17 to 20, 1994, the Josiah Macy, Jr. Foundation sponsored a conference entitled "The Role of Emergency Medicine in the Future of American Medical Care," a report on which was published in Annals in 1995. This report promulgated recommendations for the development and enhancement of academic departments of emergency medicine and a conference to develop an agenda for research in emergency medicine. The American College of Emergency Physicians' Research Committee, along with several ad hoc members, presents updates in several of the areas addressed by the Macy Report and subsequent conferences, as a status report for the development of emergency medicine research as a whole, as of late 2002.