Acute stroke management in the Caribbean: a scoping review protocol

<b>Objective:</b> Map the literature on access to diagnostic and therapeutic modalities for adult stroke care in the Caribbean to identify potential limitations in acute treatment and examine how restricted access may impact outcomes.<b>Introduction:</b> Stroke is a leading cause of death and disability in the Caribbean, yet there is limited published information on the availability and utilization of diagnostic imaging and treatment methods. Inequities in healthcare infrastructure, access to neuroimaging, and acute treatment options may contribute to poorer outcomes following stroke, particularly in the low-resource settings that characterize most of the Caribbean region. The resulting data can help inform strategies for improving access to stroke care in resource-limited communities.<b>Inclusion criteria: </b>We will consider studies focusing on ischemic and hemorrhagic stroke in the Caribbean, emphasizing access to diagnostic imaging, stroke centers, pre-hospital management, and emergent treatment. Studies examining acute stroke management capacity within the region will be considered. Studies will be excluded if they: focus exclusively on primary stroke prevention, post-acute care, longitudinal care pathways for stroke victims, or pediatric populations; are unrelated to stroke diagnosis or treatment; or are conducted outside the Caribbean.<b>Methods: </b>We will apply a three-step strategy based on the JBI methodological framework: first, a limited search to identify relevant articles; second, selection of key search terms; third, implementation into a comprehensive search strategy. Search results will be extracted and screened by 2 independent reviewers, and findings will be presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.