Emergency Preparedness: When stroke symptoms hit

Updated: Feb 19


The saying "time is brain" certainly holds true when it comes to stroke. No matter whether from an obstruction or a bleed, a stroke is a life-threatening emergency. The faster one can get diagnosed and treated, the greater the chances are for a better outcome. Traditionally, a person experiencing stroke symptoms would be brought to the Emergency Department, evaluated by the triage nurse, seen by the ER doctor, and then perhaps the Neurologist. One of these physicians would order a brain scan, the results of which would be interpreted by the Radiologist and then sent back to the ordering physician. This doctor would then either begin medication treatment (such as administer tPA if the patient had an obstruction that needed to be dissolved) or call Neurosurgery if a bleed was found or surgery was needed. A process that could take several hours. Precious, life-saving hours.


There are some new advances, however, that could reduce the time it takes to get treatment. One of these innovations is the UC Health Mobile Stroke Unit (MSU) stationed at the Springfield Township FD. When a 911 call comes in to the dispatcher that sounds like a stroke, the MSU will accompany the community EMS vehicle if that community has agreed on a dual-dispatch, and if the location is within 15 minutes of the station. EMS can also call for MSU back-up if they arrive at the scene alone and may request a “rendezvous” on the way to the hospital. The MSU is an advanced-level ambulance that houses a scanner capable of performing CTs and CTAs. A UC radiology technician, critical care nurse, EMT, and paramedic are all on board, who can communicate via video with a UC stroke-specialty physician, start lab work, and if necessary begin tPA. The destination hospital will be determined by several factors including which is most medically appropriate and patient/family choice.


Outside of these emergency transportation innovations, Mayfield Brain & Spine has been instrumental in the promotion of other time-saving advancements in stroke care. One is through the formation and expansion of a regional stroke network. Mayfield neurosurgeons are working with TriHealth, Mercy Health, and St. Elizabeth Healthcare in providing stroke intervention closer to where people live. This allows residents of the Greater Cincinnati area to get to a nearby stroke-ready hospital faster, saving valuable time.


Another advancement is through an artificial intelligence application known as “Viz.ai” (Visualization of Artificial Intelligence) that Mayfield has helped procure for Good Samaritan and Bethesda North Hospitals, and the local Mercy Health system. Instead of going through the traditional chain of specialists and tests that could take several hours, the scan results for a stroke-suspected patient are sent concurrently to the radiologist and to a cloud-based server which uses an A.I. algorithm to recognize patterns suggestive of a stroke. When such a pattern is found, it immediately and simultaneously sends an alert to all team members, including the neurosurgeon. This allows all the members of the medical team to make a collaborative decision in minutes, post-imaging.


Residents of Cincinnati should also be aware of a new development to the 911 system. More than 80% of the time when someone calls 911, they are using a mobile phone that does not signal their exact location to the dispatcher. If the caller is confused, unable to speak clearly, or loses consciousness, it can be very difficult for first responders to find them. Now there is something called Smart 911. This is an optional service that individuals can sign up for (free of charge) at www.smart911.com. By entering the information that they choose (e.g. the addresses associated with their cell phone number, contacts for loved ones, medical and vehicle information), 911 can more easily locate people in an emergency and have advanced warning of their health conditions.


Local hospitals, physicians, and first responders are doing their part to provide the best care possible for us when emergencies strike. But we must do our role in order for these innovations to be of benefit to us. Here are some suggestions:

  1. KNOW THE SYMPTOMS: Have the signs of a ruptured brain aneurysm and stroke written down somewhere that is easily accessible (your phone, your refrigerator, your wallet).

  2. GET INFORMATION TOGETHER NOW: Sign up for Smart 911. Have an up-to-date medical information card in your wallet that contains your full name, date of birth, and other identifying information; your diagnoses; surgical history and implant log; medications; allergies; religious instructions; names and contact information for your loved ones and doctors; and which hospital you wish to be transported to. Speak to your primary care provider about whether you should be wearing a medical I.D. pendant and whether you could benefit from a medical alert call system at home. Consider drawing up a living will and assigning a healthcare power-of-attorney (POA) to someone you trust, and have those forms scanned into your medical record. These are safety nets that will communicate your wishes to your doctors if a time comes when you are unable to do so yourself.

  3. CALL 911 AS SOON AS STROKE SYMPTOMS BEGIN: Not all of the possible symptoms must be present for someone to be experiencing a ruptured brain aneurysm or stroke. Call 911 immediately if there is any possibility you may be having one of these life-threatening events. Do not try to drive yourself or have someone else take you to the emergency department. Ambulances have emergency medical professionals and equipment on board that could save your life on the way to the hospital.

Stroke Level Certification by Joint Commission (See www.jointcommission.org for Stroke Level descriptions)

HOSPITAL

STROKE LEVEL

UC Health Medical Center

Comprehensive Stroke Center

UC Health West Chester Hospital

Primary Stroke Center

Good Samaritan Hospital

Comprehensive Stroke Center

​Bethesda North Hospital

Thrombectomy Capable Stroke Center

Bethesda Butler

Primary Stroke Center

Arrow Springs, Good Sam W. Ridge

Acute Stroke-Ready Hospital

St. Elizabeth – Edgewood, Florence, Ft. Thomas

Primary Stroke Center

St. Elizabeth – Covington, Grant

Acute Stroke-Ready Hospital

Mercy Jewish Hospital

Thrombectomy Capable Stroke Center

Mercy Health – West, Fairfield, Anderson

Primary Stroke Center

Mercy Health – Clermont, Rookwood

​Acute Stroke-Ready Hospital

The Christ Hospital

Primary Stroke Center

Data taken from hospitals’ websites (11/2021) and/or OH Dept of Health’s Hospital Stroke Level Recognition chart (1/31/2022).

 

Dr. Nicole Best (“Nikki”) is a Clinical Psychologist and 3-time ruptured brain aneurysm survivor. She earned her Doctorate in Psychology (PsyD) from Wright State University School of Professional Psychology, and completed a Post-Doctoral Fellowship at The Ohio State University Medical Center, Dept. of Physical Medicine & Rehabilitation, Division of Rehabilitation Psychology. Thereafter, she worked for almost 14 years in the VA Healthcare System before leaving on Disability after her 3rd subarachnoid hemorrhage. She has extensive experience performing psychotherapy and neuropsychological and decisional capacity evaluations with patients suffering from a wide range of medical conditions, including dementia, traumatic brain injury, stroke, and terminal illness.


51 views0 comments

Recent Posts

See All