Patients with a clock start of 1 April 2019 or later
All SSNAP records should be started by the admitting team, even when a thrombectomy is performed.
After listening to feedback from users and subsequent intensive development of the SSNAP analysis processes, we have now made changes which means we can endeavour to allocate the initial processes of care (e.g. scan or tPA) to the admitting team even when a thrombectomy is performed at a second centre. Previously, due to the way that analysis is performed on SSNAP we required the thrombectomy-performing team started the record on SSNAP.
Patients with a clock start before 1 April 2019
If the patient is admitted to a team and subsequently receives IA intervention at the same team then the record should be started as normal by the admitting hospital.
If a patient first presents at one hospital but is then transferred to another specialist IA intervention centre it should be the specialist IA centre that starts the SSNAP record*. Data taken from the point of arrival at the first hospital should be shared with the specialist IA centre, this will most likely comprise of:
- Time of arrival at the first hospital
- Scan time
- NIHSS on arrival
- Times of any other specialist assessments performed
The team performing the thrombectomy should enter this data as if the patient first arrived at their team. We understand that teams that refer patients for thrombectomy off site will be concerned that these patients will not be included in their team-centred 72 hour results. However it is worth reiterating that it is expected that the number of cases will be small. If such patients are transferred back to the first hospital within 72 hours then the record will be analysed for both teams in the patient-centred 72 hour results.
*If a patient first presents at one hospital but is then transferred to another specialist IA intervention centre, but subsequently does not receive IA intervention, the record can be started as normal by the admitting team.