Certified Neuroscience Registered Nurse
Q: What is the “stroke alert” and why has it been initiated at Memorial Medical Center?
A: We’ve done a very good job taking care of stroke patients but because time is so key to treating these patients we wanted to optimize our opportunity to really get to people quickly and the best way to do that is look at what already has been successful and the trauma alerts work. It’s notified. It’s paged overhead and the team knows immediately what their piece is. So that’s what we did with stroke. It’s paged overhead. There’s pagers that go off for neurology, for the laboratory and everyone can get to the patient’s bedside quickly and really optimize the care we can give them.
Q: What difference does time make in the case of a stroke? How big of an impact can that have?
A: There are very limited treatment options for stroke right now and the one that is FDA approved that is available here is tPA. tPA dissolves a blood clot but we have three hours from the time the symptoms start until we can no longer give that medication and three hours sounds like a long time but till the patient or family recognizes at home what’s going on, they activate emergency medical services, get here to the emergency department and we need to get a scan and some basic testing, you’re really fighting the clock.
Q: Does the “stroke alert” speed things up?
A:It does because immediately the laboratory knows to respond to the patient’s bedside. We have pre-established laboratory values that they know to draw. We don’t have to go through individual pieces of lab data. It’s drawn as one unit. The CT scan --- people know that they have a patient that needs to get scanned as quickly as possible. Neurology knows get down here as quickly as possible to help evaluate the patient.
Q: What are the warning signs of stroke and what should people do if they suspect someone is having a stroke?
A: Well, first of all don’t hesitate because time is brain. So that’s the most important message. If someone has a sudden neurological change, they suddenly can’t move one side of their body, their arm, their leg, they have difficulty with speaking or difficulty understanding speech, someone complains this is the worst headache of my life, those are all important warning signs and it’s better to be safe than sorry. To wait at home and extend that time of treatment or miss that treatment opportunity is really a shame.
Q: Are there ways to prevent strokes?
A: Really the best way to treat a stroke is to prevent it. We can do a lot as far as keeping our brain healthy in the same manner that we know about and have --- know how to keep our heart healthy. So managing blood pressure; make sure that patients have their blood pressure in a normal range. If someone is diabetic; that they take care of their blood sugar. They take their medicine as they should and keep that level where it should be.
Treating high cholesterol; cholesterol is the fatty build-up in arteries and it affects arteries in the brain as well as the heart and elsewhere in the body. Don’t smoke. Smoking actually takes blood vessels and constricts them so blood can’t get through as readily. All those things are important and can really help decrease your risk.
Q: What kind of extra training is available to Stroke caregivers at Memorial?
A: Caring for a stroke patient goes much beyond what we do here in the emergency department. So how can we help to educate the nurses so they recognize symptoms if something starts to occur on the floor, again, when the patient’s upstairs, making sure that people get therapy quickly. That’s the best way for rehab and recovery is to initiate that as soon as the patient is stable.
Another item is swallowing. We don’t think about it but swallowing is very complex and those muscles can sometimes be effected with a stroke. So how do we safely ensure that someone can be fed, can have a meal once they’re here, can take their medications, evaluation of stroke, using the NIH stroke scale. So there’s a lot of education going on with the nurses here.
Q: Are you excited about the “stroke alert” and what it might mean for patients at Memorial?
A: I think it is because it increases the awareness within the hospital. I think that message goes out to the community. We want to be able to do the most that we can in the quickest manner for patients when they come in and we suspect it’s a stroke.
Q: Tell me about the Stroke awareness magnet that is now available for the public.
A: Well, it’s an educational tool that you put that on your refrigerator. Those warning signs are there and it’s a good reminder. Sometimes if you’re not real sure what’s happening with yourself or with a loved one you can go to that. It’s a quick reference and know to call 911.
Q: Why is it important to call 9-1-1 if you suspect a stroke?
A: It is because people think oh, I can get to the hospital faster but the truth is when EMS is activated they contact the emergency department immediately. They’re already extending medical care to that person. So whether that’s, you know, supplemental oxygen, things that they can start, put the cardiac monitor on, start to really see what’s going on with that patient even before they hit the door. So it’s important and it’s the best way to transport someone.