FM and stroke

[IMGforNeuro]

i wanted to ask all FM guys about what FMs do in stroke.
i guess ER guys have a role in acute stroke, but do FPs also managa acute stroke?
Secondly, do you manage or follow up chronic strokes?
When do you refer a case of stroke to the neurologist/stroke team?

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[dr.smurf]

yes fp's take care of stroke pts. the rule at our hosp is this...if the pt hits the door (e.r.) and has an fp as a pcp then he/she goes to the fp service no matter how complex or simple the admission may be. so yes we get lots of cva's.

the e.r. docs usually get the inital CT to r/o bleed so the pt can then be started on asa, clopidogrel, thrombolytics, etc. the pt goes on a cva protocol...ekg to r/o afib induced emboli, cbc, coags, etc.

in my experience if its a lacunar infarct, tia, or small stroke we take care of it. a big cva, bleed, etc we almost always get the neuro guys involved.

again fp does it all!