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Stroke System

When a Stroke Occurs, Time Lost is Brain Lost!

Contra Costa Emergency Medical Services (EMS) launched a comprehensive Primary Stroke System in January 2012. The system design and implementation plan is described on this webpage. For questions about the materials on this website or information on joining our Stroke Advisory Group please contact our office at 925-646-4690 or email our Stroke System Program Manager.

Goal: To develop a comprehensive primary stroke system to be launched countywide by January 2012. Contra Costa EMS is developing the local stroke system consistent with the Statewide Plan for California: “Recommendations for the Establishment of an Optimal System of Acute Stroke Care for Adults.”

Description: The Contra Costa STROKE System program will consist of a collaborative network of JCAHO Primary Stroke Centers who work in concert with 9-1-1 Prehospital Providers, to identify patients, who may be victims of stroke and rapidly triage them to stroke centers.

Key Principles
Public Education
Receiving Centers
  • Key Principles & Definitions

    Key Principles

    Rapid stroke recognition and transport of patients to primary stroke centers is a key component to the early diagnosis and ongoing definitive treatment of patients with stoke. In all cases, the health and well being of the patient is the overriding consideration in determining patient destination. Factors to be considered include: transport time and request by the patient, family, guardian or physician.


    Stroke: Stroke, sometimes called a ‘brain attack,’ is injury to the brain, spinal cord, or retina caused by blockage or rupture of a blood vessel and/or a reduction in blood flow to the brain. There are two major types of stroke:

    • Ischemic stroke: an occlusion in a blood vessel blocks blood flow to the brain, oxygen does not reach the brain and tissue dies rapidly.
    • Hemorrhagic stroke: A blood vessel ruptures, causing bleeding into or around the brain. Both types of stroke often result in disability and death.

    Primary Stroke Center (PSC): A hospital designated by Contra Costa County EMS with rapid stroke capabilities, designed to provide rapid intervention for stroke patients consistent with Primary Stroke Center Certification Criteria of the Joint Commission program. The Joint Commissions program is based on recommendations for Primary Stroke Centers published by the Brain Attack Coalition, American Heart Association and American Stroke Association. For additional information go to

  • Background

    Stroke is a national and local epidemic. It is the third leading cause of death in California and a leading cause of serious long-term disability. Every 45 seconds, someone has a stroke and every three minutes, someone dies of stroke in the United States. Nearly one quarter of strokes occur in people under the age of 65. Stroke is among the five leading causes of death for people of all races and ethnicities. But the risk of having a stroke varies. African Americans are nearly twice at risk compared to whites and Hispanic Americans’ risk falls between the two. African Americans and Hispanics are more likely to die following a stroke than whites.

    Components of a Stroke System

    • Expeditious EMS dispatch and response
    • Pre-hospital stroke screening and patient assessment
    • Communication with receiving facilities
    • Community partnerships to promote stroke recognition and reduction
    • Stroke-ready emergency departments to provide fast, appropriate care and referral including:
      • Administration of tPA (clot-busting drug treatment when clinically appropriate and if within three hours of onset of symptoms
      • Rapid neurological imaging
      • Rapid laboratory test results
      • Access to endovascular treatments

    Early Action is Key: Patients who arrive within three hours of their first stroke symptoms tend to be healthier and have better outcomes three months after a stroke than those whose care was delayed. For the best chances of recovery, don’t wait, call 9-1-1 immediately!

  • Know the Signs of Stroke

    Stroke happens fast and symptoms include:

    • Trouble walking, dizziness, loss of balance or coordination
    • Weakness of the face, arm or leg especially on one side
    • Trouble seeing - in one or both eyes
    • Trouble speaking or understanding confusion
    • Severe headache with no known cause

    If someone experiences these symptoms

    Call 911 Act In Time

    Stroke Risk Factors

    Anyone can have a stroke, but certain behavior and medical conditions can increase your chances. Fortunately, anyone can take steps to lower their risk.

    The following websites can help you learn more about strokes and how to reduce your risk factors:

  • First Person Stories About Stroke

  • Stroke Receiving Centers

    A Primary Stroke Center (PSC) is a hospital designated by Contra Costa County EMS with rapid stroke capabilities, designed to provide rapid intervention for stroke patients consistent with Primary Stroke Center Certification Criteria of the Joint Commission program.

    As of August 7, 2014, the following hospitals have been designated as Primary Stroke Centers in the Contra Costa County EMS Stroke System:

    • John Muir - Concord
    • John Muir - Walnut Creek
    • San Ramon Regional Medical Center
    • Kaiser - Richmond
    • Kaiser - Antioch
    • Kaiser - Walnut Creek

Contra Costa Stroke System Documents


Stroke System Medical Oversight:
David Goldstein, MD
EMS Medical Director
Stroke System Program Manager:
Maria Fairbanks, RN, CEN
Prehospital Care Coordinator