Background and Aims: Prehospital delay is one of the major causes of low rate of intravenous rt-PA thrombolysis for acute ischemic stroke in China. Regional emergency systems have been proved a successful approach to improve access to thrombolysis. To improve rapid access to rt-PA thrombolysis in Shenzhen,  Shenzhen stroke emergency map, the first city  stroke emergency map,  was implemented by Shenzhen healthcare administrations. 
Methods: This map comprised certification of qualified local hospitals, identification of stroke patients, acute stroke transport protocol and maintenance of the map. We conducted a retrospective observational study to compare consecutive patients with acute stroke arriving qualified local hospitals before and after implementation of Shenzhen stroke emergency map.
Results: After implementation of map, the rate of patients receiving rt-PA thrombolysis increased from 8.3% to 9.7%(P=0.003), and the rate of patients treated with endovascular thrombectomy increase from 0.9% to 1.6%(P＜0.001). Sixteen hospitals (16/20) have an increase in the number of stroke patients treated with rt-PA thrombolysis. The median time between the receipt of the call and the arrival on the scenereduced significantly (17.0 minutes vs 9.0 minutes, P＜0.001). In Shenzhen Second People’s Hospital, the median onset-to-needle time and door-to-needle time was reduced ( 175.5 min vs 149.5 min, P=0.039; 71.5 min vs 51.5min, P＜0.001 ). Currently, there are more than 40 cities implementing stroke emergency map in China. 
Conclusions: The Shenzhen stroke emergency map improves access to rt-PA thrombolysis for acute ischemic stroke, and the novel mode has been expanded to multiple areas in China. Future efforts should be conducted to optimize stroke emergency map.

ESOC-2019