1. A. The council shall:

   1. 1. Establish emergency stroke care protocols, and
   2. 2. Support the adoption of emergency stroke care protocols by emergency medical services providers through local EMS coordinating systems.

2. B. The council shall ensure that emergency stroke care protocols:

   1. 1. Are developed and implemented in coordination with:

      1. a. Local EMS coordinating systems,
      2. b. National organizations that focus on heart disease and stroke,
      3. c. Emergency medical services providers, and
      4. d. Health care providers;
   2. 2. Include procedures for the pre-hospital assessment and treatment of stroke patients, which may include education about identifying stroke patients who may have an emergent large vessel occlusion, the blockage of a large blood vessel that causes an individual to have an ischemic stroke;

   3. 3. Provide for transport of stroke patients to the most appropriate emergency receiving facility, consistent with A.R.S. § 36-2205(E), taking into account the:

      1. a. Needs of a stroke patient;
      2. b. Availability of resources in urban areas, suburban areas, rural areas, and wilderness areas;
      3. c. Capability of an emergency receiving facility to practice telemedicine, as defined in A.R.S. § 36-3601, with specialists in stroke care;

      4. d. Location of emergency receiving facilities that:

         1. i. Are:

            1. (1) Acute stroke-ready hospitals,
            2. (2) Primary stroke centers, or
            3. (3) Comprehensive stroke centers; and
         2. ii. Participate in quality improvement activities, including the submission of data on stroke care provided by the emergency receiving facility that may be compiled on a statewide basis;
      5. e. Capability of an emergency receiving facility that is not a primary stroke center or comprehensive stroke center to stabilize a stroke patient before initiating a transfer to a primary stroke center or comprehensive stroke center;
      6. f. Capability of an emergency receiving facility that is not a primary stroke center or comprehensive stroke center to stabilize and admit a stroke patient; and
      7. g. Distance and duration of transport;
   4. 4. Are consistent with national stroke care standards; and

   5. 5. Are based on data on stroke care from:

      1. a. National organizations that focus on heart disease and stroke;
      2. b. U.S. Department of Transportation, National Highway Traffic Safety Administration; and
      3. c. Statewide data on stroke care, as available.

3. C. The council shall review and update, as necessary, the emergency stroke care protocols in subsection (A) after seeking input from:

   1. 1. Local EMS coordinating systems,
   2. 2. National organizations that focus on heart disease and stroke,
   3. 3. Nonprofit organizations that focus on the development of stroke systems of care,
   4. 4. Emergency medical services providers, and
   5. 5. Health care providers.

Historical Note

Adopted effective October 15, 1996 (Supp. 96-4). Section repealed by final rulemaking at 9 A.A.R. 5372, effective January 3, 2004 (Supp. 03-4). New Section made by exempt rulemaking at 19 A.A.R. 643, effective April 5, 2013 (Supp. 13-1). Amended by final rulemaking at 23 A.A.R. 1728, effective July 1, 2017 (Supp. 17-2).