Improving emergency room care for stroke patients

Untimely and improper treatment for strokes is a common area of medical malpractice litigation.  There are medications recognized as helpful for some stroke patients.  Reports show that overall patients are getting the help they need more quickly.

Tissue plasminogen activator (tPA) is a “clot busting” medication that has been used for several years to help patients who have new strokes caused by decreased blood flow (like from a clot).  There are well established guidelines about tPA for stroke patients (http://stroke.ahajournals.org/content/early/2015/06/26/STR.0000000000000074) that are frequently updated and agreed to by many medical specialties.

If administered timely, tPA can improve patient outcomes.  But there is a “window of treatment” outside of which it becomes riskier for patients to receive tPA.  

Although tPA has been the standard of care for a while, many patients do not get the benefit of tPA because they are not evaluated quickly enough and, therefore, cannot receive the medication fast enough for it to be given safely.  

Against this backdrop, emergency department doctors, neurologists, and other doctors that see patients shortly after stroke symptoms begin should be working hard to identify which patients may benefit from tPA and to quickly administer it to the appropriate patients.  

Fortunately, recent reports show that emergency rooms are getting tPA to stroke patients much more quickly, which will hopefully translate to better outcomes for more patients.  In fact, one study showed that in 2014, almost 50% of patients received tPA in 30 minutes or less (as compared to about 25% in 2011, 2012, and 2013).  This improved “door-to-needle” time is great news for patients.

As a patient or a patient’s family member or friend, you can help, too.  Stay informed about the symptoms of a stroke and get medical care as soon as possible after symptoms appear.

THINK YOU ARE HAVING A STROKE? CALL 9-1-1 IMMEDIATELY! F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you’ll know that you need to call 9-1-1 for help right away. F.A.S.T. is:

Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven? Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly? Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.

Credit: strokeassociation.org