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A minute delay can mean a week of recovery for stroke patients.opinion

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Dr. Sandra Narayanan

As we mourn and remember the lives of more than 500,000 people lost by COVID-19 and the socio-economic turmoil it caused, Pennsylvania citizens should minimize the effects of the virus as the spring months begin. You need to stay vigilant. Pandemics have been a central focus of the medical community for the past 12 months, but attention should also be paid to other fatal illnesses for which immediate treatment is essential to ensure the best results for the patient. ..

Among these illnesses is stroke, which is a major cause of brain-related deaths and disabilities in Pennsylvania. Brain Awareness Week (March 15-21) offers all of us the opportunity to work on improving triage and transport protocols for stroke patients this year. This is an effort to help reduce disability and save lives.

For stroke patients, a one-week recovery is required if delayed every minute before receiving appropriate treatment. Stroke patients who are quickly transferred to the most appropriate hospital for treatment have the best opportunity to survive and regain independence. Therefore, people who are experiencing stroke symptoms such as loss of speech, drooping face, and weakness in the arms and legs can immediately dial 9-1-1 for life-saving and preventative care. It is important. Obstacle.

At the same time, first responders need to be authorized to triage patients suffering from severe strokes and transfer them to the optimal facility for treatment. Known as Comprehensive (Level 1) Stroke Centers, these facilities are very similar to Level 1 Trauma Centers. They have a highly trained neural interventional care team, including doctors, nurses and technicians. These teams provide life-saving treatment with minimal invasiveness called mechanical thrombectomy. It uses a catheter inserted into the leg or wrist to reach and remove the blood clot. This reopens the occluded arteries in the brain and quickly reestablishes important blood flow.

Appropriate prehospital protocols must be implemented for stroke patients to have rapid access to this treatment. These protocols should ensure triage and direct transport of stroke patients, especially the most deadly stroke patients known as emergency large vessel occlusion (ELVO), and send them to a Level 1 stroke center for emergency life-saving treatment. ..

The personal and social costs of failing to improve stroke triage and transport protocols are devastating. The patient’s lifelong potential for disability or death and the cost of the United States, including medical services and absenteeism, is approximately $ 34 billion annually. These costs are reduced in all patients who receive effective stroke treatment, leading to better results. The most severe stroke thrombectomy treatment is statistically one of the most effective treatments in medical history.

As we continue to adapt to the new reality of living in a world with the coronavirus, we must avoid complacency in life-threatening emergencies such as strokes and heart attacks. There are highly effective and high quality research-led therapies for these conditions, and it is our duty to provide patients with the best access.

Many lessons that policy makers can learn from today’s pandemics are that a systematic approach to care provides the greatest social benefit. By improving emergency transport and inter-facility protocols that begin with a stroke, patients can be assured that they will arrive at a facility equipped for treatment without delay.

My colleagues and I are dedicated to helping the state improve its stroke protocol in such a way that patients arrive in the right place at the right time and ultimately save more lives. doing. Together, we know that we can find opportunities to guide Pennsylvania on the right path to improving the outcomes of stroke patients and their families.

Dr. Sandra Narayanan is an associate professor of neurology and neurosurgery at the University of Pittsburgh School of Medicine. She is a member of the Society of NeuroInterventional Surgery and supports stroke anticipation campaigns to improve the care system for stroke patients.

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