At the intersection of neurology, neurocritical care, and internal medicine sits stroke — a field that demands seamless collaboration when seconds matter most.

Over the past three years, we've refined a unique model at our center: code stroke nurses (CSRNs) — critical care trained — who provide conscious sedation during endovascular thrombectomy (EVT), paired with a pre-EVT huddle that establishes bilateral situational awareness between stroke and anesthesia teams. What we've learned is clear: most EVT cases can be done effectively with conscious sedation, which remains best practice. But conscious sedation isn't a solo sport requires a truly collaborative team approach.

The changing landscape of stroke care demanded more. Our physicians needed proper, dedicated training for conscious sedation. Not borrowed time. Not assumed competence. Dedicated simulation.

So we built it.

Canada's first dedicated simulation for conscious sedation and emergencies during thrombectomy — jointly run with anesthesia and our code stroke nurses. We also carved out specific training time for our stroke providers to gain expertise in ACLS from a neurology background.

This is Canada leading.

What does this mean in practice?

• Stroke providers who understand ACLS principles
• Collaborative workflows between anesthesia and code stroke nurses
• limited-in-scope conscious sedation for EVT
• Standard operating procedures for contingencies — because when things go sideways, you need a plan that everyone knows
• pre-EVT huddle with anesthesia and intra-involvement of anesthesia as needed

The gears of acute stroke care are complex. Conscious sedation sits at a critical junction where neurology, critical care, and anesthesia must mesh smoothly. This simulation ensures they do.

The future of stroke resuscitation isn't just about what we do — it's about how we train to do it together.

#StrokeNeurology #EVT #TorontoNeurology #NVUProud #StrokeResus #ConsciousSedation #simulation