Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Article Title

Small Town Stroke


Emergency Medicine


Dr. Elyse Watkins, DHSc, PA-C, DFAAPA


This review article will examine the persistent obstacles encountered in rural critical access hospitals (CAH) for patients presenting with acute ischemic stroke (AIS) and synthesize strategies that can be utilized immediately to reduce the growing disparity of outcomes between the rural and urban patient populations. In the last 25 years the treatments for AIS have increased, evolved, and improved but today not all hospitals are able to treat patients with AIS, and patients presenting to CAHs are less likely to receive thrombolysis. The rapid evolvement of treatment for AIS has paralleled a disparity of outcomes between patients with AIS presenting to CAHs and urban hospitals but strategies exist at multiple levels of intervention that can help decrease the developing disparity.


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