North Dakota Mission: Lifeline® 

Mission: Lifeline Stroke is a program for transforming stroke care by focusing efforts on connecting all of the components of acute stroke care into a smoothly integrated system that reinforces use of evidence-based guidelines, measures performance, identifies gaps, and engages in improvement projects at a systems level. The stroke system of care begins with community recognition and preparedness to identify stroke and continues all the way through hospital discharge, into rehabilitation and the initiation of secondary prevention. It brings together hospitals, ambulance services, non-transport medical first response agencies, emergency communications centers, emergency medical service regulatory and medical direction agencies, local government, local media, and payers to forge a proactive system of stroke care that saves and improves lives.

The American Heart Association and American Stroke Association (AHA/ASA) requested that its National Mission: Lifeline Stroke Committee craft a consensus algorithm that was subsequently reviewed by numerous stroke committees within the organization. This algorithm seeks to balance the benefits of rapid, early access to EVT for patients with suspected LVO with the potential harm of delayed initiation of IV Alteplase. A thorough review of current guidelines and studies was conducted to help develop the algorithm. As with any algorithm, it should augment but not replace clinician judgment and may need tailoring to address the needs of the communities that implement it.

Cardiovascular disease (CVD) is the number one leading cause of death in the US and North Dakota.  According to Heart Disease and Stroke Statistics—2017 Update A Report From the American Heart Association An estimated 92.1 million US adults have at least 1 type of CVD. By 2030, 43.9% of the US adult population is projected to have some form of CVD. Stroke is the second-leading cause of death in the world and a leading cause of adult disability, with ischemic strokes accounting for about 87% of all strokes. Every year, approximately 795,000 people in the United States will have a stroke. About 610,000 of these are first or new strokes. One in four are recurrent strokes.  

Time is of the essence. Two million brain cells die every minute during stroke, increasing risk of permanent brain damage, disability or death. Recognizing symptoms and acting FAST to get medical attention can save a life and limit disabilities. ND Mission: Lifeline Stroke’s innovative regional collaboration will work to ensure compatibility, consistent training and uniform protocols for both transporting and treating stroke patients across the state.

Staff Leads:

Mindy Cook, BSN
Sr. Quality and Systems Improvement Director
American Heart Association
2750 Blue Water Road, Suite 250, Eagan, MN 55121
Office: (952) 278-7938 
Fax: (952) 835-5828

Janna Pietrzak, RN, BSN
Mission: Lifeline Stroke Stroke Director
American Heart Association
1005 Twelfth Ave SE
Jamestown, ND 58401
Phone: (701) 730-3305

North Dakota Cardiac Systems of Care Task Force (link opens in new window)(link opens in new window)

North Dakota Stroke Systems of Care Task Force(link opens in new window)(link opens in new window)

AHA GWTG Improvement Registry Login

Mission: Lifeline Toolkit (PDF)(link opens in new window)(link opens in new window)

PE Curriculum Materials


North Dakota Mission: Lifeline Stroke & Cardiac Conference 
October 24-25, 2018
Hilton Garden Inn Fargo, ND 


FAST ED: A Novel EMS Screening Approach for Stroke Triage (PDF), Nirav R. Bhatt, MD, Marcus Stroke & Neuroscience Center, Emory University/Grady Memorial Hospital 

Shifting Early Acute Stroke Management Paradigm in Rural Critical Access Hospitals (PDF), Mark Klabo, MPAS, PA-C, CHI Mercy Health Valley City

Cardiac Ready Community: Road to Success (PDF), Alana McClellan, CHI Mercy Health Valley City

EMS and Nursing Considerations in VAD Patient Care (PDF), Brittany Butzler BSN, RN, Froedtert and the Medical College of WI 

All About STEMIs (PDF), Brittney Urvand, RN, BSN, CCCC, Essentia Health Fargo 

Is There Such a Thing as Being Too Young to Have a STEMI? (PDF),  Brittney Urvand, RN, BSN, CCCC, Essentia Health Fargo

Atypical Symptoms (PDF), Sarah Miller, RN, Sanford Bismarck 

Behind Closed Doors: Improving our Door to Needle Times (PDF), JuLann Wiseman, RN, CHI St. Alexius Health Bismarck 

Sanford Bismarck: Deficit Vs NIHSS in tPA Administration (PDF), Samantha Richter, RN

Hypertension Update What’s New in Prevention (PDF), Joshua Wynne, MD, MBA, MPH, UND SMHS

STEMI Coordinator Case Study: Do I Really Need to Call 911? (PDF), Joan Reis, CHI St. Alexius Health Bismarck