Prevent Lasting Stroke Damage

Would you quickly realize if you or someone you know were having a stroke?

A stroke can be thought of in the same way as a heart attack. A stroke is like a “brain attack,” occurring when part of the brain is cut off from vital blood flow and oxygen due to a blood clot or a broken blood vessel. The results can be devastating. In fact, two million brain cells die every minute that your brain is deprived of blood and oxygen. Yet, the National Stroke Association has reported that one in six Americans cannot name a single stroke symptom.

Unfortunately, many people wait too long to seek help. A UCLA survey of records from 905 hospitals nationwide found only 28% of people who suffered a stroke sought help within an hour of experiencing symptoms, which is considered the critical period to respond for the best chance to prevent lasting damage. The majority of these patients arrived at the hospital more than three hours after symptoms began.

B.E. F.A.S.T. in identifying and responding to a potential stroke

Common stroke symptoms include a sudden, severe headache, sudden numbness or weakness of the face, arm or leg, loss of balance or sudden trouble seeing from one or both eyes. The B.E. F.A.S.T. method is a good way to remember the keys to being prepared to spot and respond quickly to a stroke:

• Balance – Can the person maintain their balance or coordination?
• Eyes– Can the person see out of one or both eyes?
• Face – Can the person smile without one side of the face drooping?
• Arms – Can the person raise both arms without one arm drifting down?
• Speech – Can a simple sentence be repeated without slurred speech?
• Time – If you answer “no” to any of these questions, call 9-1-1 or take the patient immediately to the nearest hospital emergency room. It is not recommended that you drive yourself to a healthcare facility if you suspect you’re having a stroke

Advanced stroke assessment

Across our larger healthcare network, HCA Healthcare, our providers use a proven rapid assessment approach to swiftly assess potential stroke patients within 24 hours of onset symptoms. Collectively, this enables our network to respond to strokes 38.3% faster than the national standard.

Our rapid assessment program is based on four pillars, and used when a patient is first admitted with stroke symptoms.

• Stroke alert activation. This is a screening tool to identify positive criteria for abnormal functioning of specific areas, like numbness or weakness in one side of the body.
• “Launch pad” or “pit stop.” This is a designated area in the ER for the arrival of stroke alert patients.
• An initial assessment, with glucose and blood pressure readings, is conducted before transporting patients to a computerized tomography (CT) scan.
• A non-contrast head CT with preliminary interpretation, or “wet read,” is completed within 20 minutes of arrival.
• Stroke kit. We make sure that supplies necessary to evaluate and treat stroke alert patients are readily accessible.
• Decision to treat with alteplase administration. Following the CT scan, a doctor will determine whether to administer intravenous (IV) alteplase to treat severe conditions caused by blood clotting.

Stroke treatment

A drug called tissue plasminogen activator (t-PA) can dissolve blood clots that cause most strokes, but the medication must be given within three to four hours of stroke effects, or it may do more harm than good. Studies show that stroke survivors who receive t-PA the soonest have the best chance of recovering with little or no disability after three months.

Studies have found that less than 30% of U.S. patients are treated within the recommended window of 60 minutes or less (for patients being treated with t-PA). Across our network, our facilities average a DTN (door-to-needle) time of just 37 minutes.

In the past six years, the treatment of large vessel strokes (which typically causes the greatest disability) has been revolutionized by neuro-thrombectomy, which is conducted through a catheter procedure that can directly remove clots in large brain blood vessels.

Our network, HCA Healthcare, has multiple comprehensive thrombectomy-capable stroke centers to significantly improve the outcomes of large vessel strokes and, for selected patients, issue treatment within 24 hours of onset stroke symptoms.

Know what to look for and act quickly

Time is of the essence when someone is experiencing a stroke, and our patients receive timely, state-of-the-art stroke care driven by proven clinical protocols. However, it is important that everyone — friends, family, neighbors — understand just what a time-sensitive situation a stroke is.

Swiftly identifying stroke symptoms and fast action can truly save a life and improve a patient's chances of receiving treatment sooner.