Bringing the ER to the stroke patient!

We are trying to do a better job educating our patients about the warning signs of stroke, and that if they think they might be having a stroke they should act FAST and call 911 to get to the ER as soon as possible.

However, despite these efforts only 5% of US stroke patients get to the ER in time to receive clot busting therapy to treat their stroke.  Furthermore, the quicker the drug is given, the better the outcome, TIME IS BRAIN!

We would like to see patients getting treated within one hour of the onset of their stroke, but because of the time it takes to get to the hospital and get evaluated in the ER this is rarely possible.

A pilot study in Texas is looking at getting stroke therapy administered faster by bringing the ER to the stroke patient.

The project brings a mobile CT scanner and a stroke neurologist (via telemedicine) to the patient in a specially equipped ambulance.  The investigators hope to see stroke patients getting treated faster and improved outcomes.

A more limited role for “stroke rescue”

Recent randomized controlled studies continue to debunk the perceived benefits of mechanical clot retrieval over FDA approved intravenous thrombolysis with tissue plasminogen activator (tPA) for the treatment of acute stroke.

Intravenous tPA  is much more widely available than the costlier mechanical clot retrieval systems.

We recently posted a study that showed both treatments were equally effective for acute stroke treatment.

Another study showed that outcomes were the same for patients who received intravenous thrombolysis alone compared to those patients who received iv tPA and were then transferred to a “stroke rescue” center for mechanical clot retrieval (so called “drip and ship”).

In other words, most stroke patients can be effectively treated at primary stroke centers.

If you think you are having a stroke, call 911 and get yourself to the nearest hospital,

Time is brain!

Mechanical clot retrieval may still be an option for stroke patients who have an occluded artery, but cannot receive tPA because they are on blood thinners, have had recent surgeries, or are seen more than 4.5 hours since stroke onset.

Yet more data that supports the importance of stroke prevention over stroke treatment.

Click here to find out more about our innovative TIA rapid evaluation center, which targets high risk patients for intensive stroke prevention strategies.