In suspected stroke or TIA, when should initial hospital notification be made to confirm destination?

• A. After arrival at the hospital
• B. During transport but only if the patient deteriorates
• C. Early to confirm destination
• D. Never; rely on EMS to guide transport

Answer: (C)

In suspected stroke or TIA, time is essential and the receiving team needs to be ready as soon as possible. The best approach is to notify the hospital early to confirm the destination and activate the stroke protocol en route. This pre-arrival notification allows the receiving facility to activate the stroke team, prepare immediate imaging like a CT, have the ED and radiology ready, and confirm that the patient will be taken to an appropriate facility such as a designated stroke center. By confirming destination ahead of arrival, treatment decisions can start sooner, reducing door-to-needle time and increasing the chances of a favorable outcome. Delaying notification until after arrival, or waiting only if the patient deteriorates, wastes precious minutes and can hinder rapid evaluation and treatment, while never notifying misses a critical opportunity to prepare.