Never underestimate the power of preparation, planning and teamwork.
When an otherwise healthy 84-year-old male suffered one-sided paralysis and slurred speech in downtown Elmhurst, all the stars aligned. A call was made to 911 without delay, triggering teams and protocols into action, and kicking off a time-limited treatment countdown.
“Time is brain” is a common phrase used to emphasize the critical need to seek medical attention immediately for stroke symptoms. Early detection and intervention may decrease permanent damage from a stroke and increase the effectiveness of treatment. For this patient, each important step of the process played out ideally.
“This is such a cool story,” says Michele Gobber, MSN, RN, SCRN, CNL, CCRN-K, Elmhurst Hospital Stroke Coordinator. “Emergency medical services, as well as hospital staff, train for situations like this to ensure the door-to-drug time is as short as possible.”
Gobber is referring to the timing of the administration of drugs like alteplase, a thrombolytic medicine used to break up blood clots like those that cause stroke. These medicines can be extremely effective in limiting or reversing symptoms, but must be given within a 4.5-hour window of symptom onset.
Elmhurst Hospital guidelines call for the medicine to be given to patients experiencing a stroke within 45 minutes of arriving at the hospital. In this case, the patient received it within 40 minutes and started to experience immediate improvement. The patient was in the ER for two hours before being transferred to the Intensive Care Unit.
“Before he left the ER, all his symptoms had resolved,” says Gobber. “When someone has a massive stroke at that age, they usually can’t go right home, but this gentleman went home several days later without any assistance needed.”
Gobber attributes this patient’s success story to near-perfect execution of practiced protocols across multiple facets of the healthcare team, a team that sprung to action following the lead of loved ones who recognized the signs of stroke.
In addition to the early detection and action taken, what else went right? The answer is, a whole lot.
“When they have a potential stroke patient, Elmhurst medics draw blood in the field, so we don’t waste precious minutes doing it in the ER,” says Gobber. “They use a technology called E-Bridge to share registration details so patients can be registered before arrival.”
Pre-registration means tests and treatments can be preordered to save precious time at the hospital. When a patient arrives, not a moment is wasted.
“Stories like this need to be celebrated,” says Gobber, who feels this one fits perfectly into Edward Elmhurst Health’s Healthy Driven initiative. “This is why we practice and have protocols. This stuff really works.”
The National Stroke Association encourages memorization of the acronym FAST to enable early recognition of stroke symptoms and timely treatment:
FACE: Ask the person to smile. Does one side of the face droop?
ARMS: Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
TIME: If you observe any of these signs, call 911 immediately.
Learn more about neuro services at Edward-Elmhurst Health.
To learn if you’re at risk for stroke, take a free, five-minute StrokeAware assessment.
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