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ED Visit Is Teachable Moment on Stroke Care

By Stacey Kusterbeck

Sending patients to the ED sooner is one way to improve access to high-quality, time-sensitive stroke care, thus improving long-term outcomes. “However, we still lack knowledge about how we can better educate the public about stroke warning signs and symptoms. This is especially critical for Black adults, who have a higher risk of stroke and stroke mortality,” says Tracy Madsen, MD, PhD, FAHA, FACEP.

There also are well-documented race-based disparities in treatments for acute stroke, including the use of clot-busting medications and procedures to remove clots that block vessels in the brain and lead to stroke.

Madsen and colleagues provided an ED-based educational intervention to 100 Black patients at an urban facility, including video, brochure, and verbal counseling.1 Study participants demonstrated significantly better self-efficacy in the follow-up period after the educational intervention. Specifically, participants were much more likely to demonstrate confidence in the ability to recognize stroke symptoms in themselves or others and were more likely to feel confident about calling 911 in the case of stroke warning signs.

“The ability to recognize stroke warning signs and call 911 for themselves or a family member is critically important in this population and has the potential to connect more patients to timely stroke care,” Madsen says.

Madsen recommends emergency providers be aware that ED visits often present teachable moments to inform patients about signs and symptoms of stroke. “This is especially important for patients who may be at increased risk of stroke, including those who have had previous strokes, those with risk factors including hypertension or diabetes, or those in communities at increased risk due to systemic racism and lack of access to preventive care,” Madsen says.


1. Shufflebarger EF, Walter LA, Gropen TI, et al. Educational intervention in the emergency department to address disparities in stroke knowledge. J Stroke Cerebrovasc Dis 2022;31:106424.