Patients with a clock start of 1 April 2019 or later
The SSNAP record should be started by the team performing the initial assessments. If your team sees the patient first and performs the initial assessment (even if they were not admitted to the hospital) you should start the record and then transfer to the thrombectomy centre.
Please only record data that your team collected. If your team did not perform the intra-arterial intervention, please answer 'No' or leave blank: Q2.11 Did the patient receive an intra-arterial intervention for acute stroke?. Only the team performing the thrombectomy should enter ‘Yes’ for Q2.11.
If the record is transferred within 24h, you need to complete section 1, 4 and 7 to be able to transfer the record. Section 1-3 can be edited by the second team.
If the record is transferred within 24h-48h, you need to complete section 1, 2, 4 and 7 to be able to transfer the record. Section 1-3 can be edited by the second team.
If the record is transferred within 48h-72h, you need to complete section 1, 2, 4 and 7 to be able to transfer the record. Section 1-3 can be edited by the second team.
For patients thrombolysed in ED who do not go on to a ward you can enter these options:
1.14: ITU/ CCU/ HDU
4.7: Date rehabilitation goals agreed: No goals
4.7.1: If no goals agreed, what was the reason?: Patient medically unwell for entire admission
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.
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