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Every Minute Counts When It Comes to Stroke Care

Diagnosing stroke and administering brain-saving treatment can be challenging in the minutes and hours following the onset of an acute stroke – but every minute counts.

Dr. Adam KellyAdam Kelly, M.D., Chief of Neurology at Highland, says a recent study published in the Journal of the American Medical Association shows just how crucial it is for physicians and patients to recognize the signs and symptoms of stroke early.

“We know that ‘time is brain,’ and this is another study demonstrating the importance of this,” Dr. Kelly says.

In the study of more than 58,000 stroke patients nationwide, researchers found those who received blood-clot dissolving treatment (IV tPA) more rapidly after symptom onset had better outcomes. Administering this type of treatment was associated with:

  • Fewer in-hospital deaths and intracranial hemorrhage (bleeding in the skull)
  • Higher rates of independent walking ability at discharge
  • Higher rates of discharge to home

Doctors only have a small window of time – usually between three and 4.5 hours – to administer IV tPA following onset of a stroke.

“There is a lot we have to do: confirm the diagnosis of stroke based on history and exam, blood work, EKG, CT scan and discuss risks and benefits of treatment,” Dr. Kelly says. “Sometimes patients are not able to provide their history, so this needs to be tracked down through family and others.”

Dr. Kelly and Highland Hospital participate in the Stroke Treatment Alliance of Rochester (STAR), a community-wide effort aimed at providing consistent and immediate stroke care at all area hospitals.

While hospitals are working to improve care, Dr. Kelly says patients and their families can also have an impact on early stroke diagnosis and treatment.

“Hospitals and physicians need to be ready to deliver acute stroke care as quickly as possible once a patient arrives, but members of the public need to be aware of the signs of stroke, so they can call 911 right away,” Dr. Kelly says. “In this study and in many others, patients who arrive by ambulance were more likely to receive tPA quickly, so calling 911 and coming in by EMS could save lives.”

Dr. Kelly published a study last year on the importance of prompt diagnosis and care following the onset of stroke. Read more.
 

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