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Spot a stroke, save a life: Hospital focused on helping community identify strokes quicker

Mary Beth TeSelle

‘BE FAST’ to spot a stroke

B – Balance (loss of balance, dizziness)

E – Eyesight (vision loss or disturbance)

F – Face (facial drooping)

A – Arm (weakness in an arm or leg)

S – Speech (slurred speech or difficulty speaking)

T – Time to call 911 (if a person shows any of these symptoms, even if the symptoms go away, call 911)

Source: American Stroke Association

Every year more than 795,000 people in the United States experience a stroke – that’s one stroke every 40 seconds.

Stroke is the fifth leading cause of death in the U.S. and is a leading cause of disability in adults. Recognizing symptoms early and getting treatment quickly can make a big difference when it comes to both surviving and recovering.

“According to the CDC, patients who arrive at the emergency room within three hours of their symptoms have less disability three months after their stroke than those who receive delayed care,” explains Dr. Avijit Baidwan, Dignity Health Sierra Nevada Memorial Hospital Stroke Program Medical Director. “That is why it is so important for everyone to understand stroke symptoms and take action immediately.”

Baidwan and the entire stroke team at SNMH are committed to not only caring for those affected by stroke but working with the community to increase understanding about stroke.

“When it comes to stroke, every second counts,” says Shannon McCrea, BSN, RN, CCRN, SNMH Stroke Coordinator.

Stroke occurs when a blood vessel to the brain is either blocked by a clot (ischemic stroke) or ruptures (hemorrhagic stroke). When this happens, part of the brain stops getting the oxygen and nutrients it needs, and brain cells begin to die.

Nearly two million brain cells die each minute a stroke goes untreated, which is why recognizing the signs early is so essential.

The challenge, according to McCrea, is that initial stroke symptoms may be mild. “Early signs can be subtle, which makes it easy for the person experiencing the stroke to be in denial and waste precious time getting medical treatment.”

Both McCrea and Dr. Baidwan point to the acronym B.E. F.A.S.T. as a great tool to help people understand and remember the telltale signs of stroke. [See sidebar] “BE FAST” expands on the previously used “FAST” – adding two additional symptoms so that the acronym covers 95% of acute stroke symptoms.

“Anyone experiencing changes in balance, eyesight, or speech, or facial droop or arm or leg weakness, needs immediate medical attention,” said Dr. Baidwan. “Patients seen quickly are more likely to be candidates for the powerful clot-busting drug tPA (tissue plasminogen activator), which is most effective within the first few hours following the onset of stroke symptoms. Dialing 9-1-1 and getting immediate treatment may minimize the long-term effects of a stroke.”

As a certified Advanced Primary Stroke Center, SNMH provides the community with comprehensive stroke care, following stringent guidelines set by American Stroke Association standards. SNMH is also part of the Dignity Health Neurological Institute, which provides a pyramid of care and includes the Comprehensive Stroke Center at Mercy San Juan Medical Center in Carmichael – the first and only Comprehensive Stroke Center north of the Bay Area.

“Being able to connect patients suffering more complex stroke cases to the advanced neurological care available at Mercy San Juan is such a gift for our community,” explains McCrea. “This enables us to provide a comprehensive, team approach to stroke care.”

SNMH’s stroke program began in 2008, through support of the SNMH Foundation’s “Stroke of Luck” Campaign. Through gifts generated by the campaign, SNMH was able to provide for advanced stroke-specific education for nurses, technicians and physicians; initial stroke certification by the Joint Commission; and a telemedicine robot used for neurology consultations.

SNMH became a Certified Primary Stroke Center in 2009, as recognized by the Joint Commission. Currently SNMH serves an estimated population of 99,000, of which approximately 24% are 65 years or older (a population at higher risk for stroke).

“The population we serve covers approximately 974 square miles,” explains McCrea. “To compensate for the distance within the county, and the distance from our nearest major city of Sacramento, SNMH has opted to own their ambulance service. By owning our service, we are better able to meet our time to treatment goal and provide stroke patients the care they need as quickly as possible.”

This strategy is made possible through the SNMH Foundation and community support.

While SNMH has been proactive in developing a stroke program that can provide care quickly and effectively, McCrea points out that the hospital’s stroke team must still rely on the community to take the first step.

“Please, take a moment and familiarize yourself with the signs of a stroke. And if you suspect someone is experiencing a stroke, call 911! The more quickly a stroke patient gets to us, the better their chances of survival and recovery.”

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