For People Who Are Having a Stroke, the Timing and Quality of Care Makes
a Big Difference in Recovery
One of the most important factors in stroke recovery is time. The faster
a patient is evaluated and treated, the better the chance he or she will
fully recover from the damaging effects of a stroke.
Orange County residents who live near
St. Jude Medical Center are lucky — they’re close to an Advanced Comprehensive Stroke
Center as designated by the American Heart Association, the American Stroke
Association and The Joint Commission, an independent, nonprofit organization.
What does this mean? Simply that St. Jude Comprehensive Stroke Center is
one of the best in the country, a designation based on the expertise of
the stroke team, door-to-treatment times and stroke education efforts,
among other factors.
Getting the right treatment fast
“The ER team at the Comprehensive Stroke Center is ready to move
into action as soon as an EMS professional calls in with a ‘code
stroke’ alert,” says Laura Ramos, Chief Nursing Officer at
St. Jude Medical Center.
The CT scan is immediately cleared for the incoming patient and a team
of stroke physicians and nurses gathers in the ER to receive the patient,
says Ramos. They do a comprehensive assessment of the patient upon arrival,
then send him or her for a CT scan to determine the type and severity
of the stroke.
About 87% of strokes are ischemic, according to the American Heart Association.
This means a blood vessel is blocked by a clot, depriving the brain of
blood and oxygen. The treatment is a drug called tissue plasminogen activator,
or TPA, which breaks up the clot.
Most hospitals aim for a 60-minute time period between the moment a patient
enters the ER and when that patient receives TPA.
“We well surpass that,” says Ramos. “For the last two
years, our goal for door-to-TPA has been 45 minutes. We have administered
treatment as quickly as 12 minutes.” She attributes this quick time
to the readiness of the multidisciplinary team and the immediate availability
of the brain imaging technology.
Sometimes surgery is required to extract a clot or to stop bleeding in
the case of a hemorrhagic stroke. The Comprehensive Stroke Center has
a “biplane suite” — advanced medical imaging technology
used by neuro interventional radiologists and surgeons to precisely target
“We take care of any type of stroke,” says Ramos. “We
have a multidiscipline team of neurospecialists available at all times
and an ICU team of intensivists [critical care physicians] who are board-certified
in neuro-critical care,” says Ramos.
Recovery from a stroke can take weeks and months. Patients sometimes need
to relearn simple tasks like walking, eating, getting dressed and talking.
The goal of rehabilitation is to reverse the effects of stroke and resume
normal life as much as possible. “We offer stroke-specific physical
therapy, occupational therapy, speech therapy — we have an entire
team to help get the patient back to the highest level of functioning,”
But when one member of a family has a debilitating stroke, often the rest
of the family needs help adjusting too. Ramos says that the Center offers
outpatient rehab and support groups. “We prepare the patient for
going home with a holistic approach, whole-person care for full recovery.”
Each year, about 795,000 people experience a stroke, according the American
Heart Association, and strokes are the leading cause for long-term disability.
But stroke deaths are declining, and experts say this is partly due to
improvements in emergency care and treatment.
St. Jude’s Comprehensive Stroke Center works to spread information
about strokes by educating EMS professionals on how to recognize stroke
symptoms, and personnel in neighboring hospitals on how to improve their
level of care of stroke patients.
The Center also works with community partners to educate Orange County
residents about lifestyle changes that can help prevent strokes in the
first place, says Ramos. These include stopping smoking, keeping blood
pressure down, getting exercise and maintaining a normal weight.
Signs of stroke
Here are some signs that indicate a person is having a stroke. If you notice
any of these symptoms, in yourself or someone else, call 911 immediately.
- One side of the face droops
- One arm is weak or numb
- Slurred speech
- Sudden confusion, trouble speaking or understanding speech
- Dizziness, sudden trouble with walking or balance
- Sudden severe headache
Source: American Stroke Association
(This article originally appeared in OC Catholic, May 2017)