Provincial Referral and Transport Process for Endovascular Thrombectomy - Process Flowchart

Oct 5, 2026

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Provincial referral and transport process for endovascular thrombectomy (EVT) stroke patients outlines eligibility screening based on imaging protocol confirmation and staged decision points. The flow specifies when to contact CritiCall Ontario and the telestroke neurologist, how the referral mapping directs communication with the designated endovascular capable centre and stroke endovascular team, and how consultation is initiated. It then governs transportation planning, including escort requirements, ETA coordination, transport mode selection via the One-Number-to-Call process, EMS escort triggers, and transfer acceptance, with notes on tPA status and potential overrides by the referring physician.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Eligibility and Telestroke Referral

EVT candidate determination

Telestroke neurologist and CritiCall Ontario contact

Transportation Planning and Transfer

Referral mapping and centre selection

Escort and transport mode requirements

ETA, ventilation risk, deterioration risk, and tPA status

Transfer acceptance and EVT site procedure

Provincial Referral and Transport Process for Endovascular Thrombectomy Stroke Patient is confirmed as potential EVT patient by Imaging Protocol. CNerpiiCorsiarcloilinlOgganisrnsai-oiccnaicaOlolnanTtnaNtcosoTnTneseulnelleestsctatrtsrotiee rCeqauNlleeCsurtritToielColaeglsiltsartndoke ~~ ~~Yes~~ ~~ Telestroke site? ~~ ~~No~~ ~~~~ ~~NoYes~~ ~~ stsroFoupkeplltieesloicamentsgnal/rrgtoteiotestnatracroloklnpsserpecoostecrnetatesarotocuptrieate Telestroke Neurologist contacts CritiCall Ontario with direction to contact the Stroke Endovascular Team at the designated Endovascular Capable Centre. CritiCall Ontario will consult the referral mapping and contact the switchboard atthe closest Endovascular Capable Centre to request the Stroke Endovascular Team. Call CritiCall and request a consultation with the Stroke Endovascular Team. Yes Yes No Follow local/regional processes for tPA/ management of stroke patients. Is patient eligible for EVT? Potential Candidate for EVT? Yes No LEGEND Follow local/regional processes for tPA/ management of stroke patients. Physician overides recommendation. Yes Yes Yes Yes Yes No No No No No No No Follow local processes for arranging transportation. CritiCall system recommends need for escort in accordance with the one-number-to call process. CritiCall contacts transportation provider to obtain ETA. Patients repatriated to “home hospital”with stroke unit within 48 hours. CritiCall Ontario system recommends mode of transport in accordance with One-Number-to-Call (ONTC) process (Appendix E) . Escort Required. CACC/Land +/ -escort (where geographically appropriate) . EVT procedure performed. Patient transferred to EVT Site. Patient accepted for transfer? Is the patient recieving normal saline at a rate >=100 cc/hour? Does the referring physician agree with the recommended mode of transportation? Will referring site use CritiCall to arrange transportation? Is ETA appropriate? Does the patient require mechanical ventalation? Is the patient at risk of deterioration? Is the patient receiving tPA or have they received tPA? June 2019 * The referring physician may still choose to override if another mode of transport is preferred. If the choice is to override, referring physician and criticall will confirm responsibility for arranging transport. Do local EMS protocols require escort?

FAQs

How does a patient become a potential EVT candidate in this process?

The patient is confirmed as a potential EVT patient through the imaging protocol. The flow then includes explicit eligibility checks for whether the patient is eligible for EVT and whether they are a potential candidate for EVT.

Who contacts CritiCall Ontario and what is the purpose of the referral mapping?

The telestroke neurologist contacts CritiCall Ontario with direction to contact the stroke endovascular team at the designated endovascular capable centre. CritiCall Ontario consults the referral mapping and contacts the closest endovascular capable centre to request the stroke endovascular team.

What transportation steps determine escort needs and the transport mode?

CritiCall recommends escort needs under the one-number-to-call process and contacts the transportation provider to obtain an ETA. CritiCall Ontario then recommends the mode of transport via the One-Number-to-Call (ONTC) process, and the flow includes checks such as whether escort is required, whether ETA is appropriate, and whether local EMS protocols require escort.

Oct 5, 2026

Upload by moss~