Tonawanda News

May 28, 2013

Doctors suggest using ambulance when stroke symptoms arise

By Danielle Haynes danielle.haynes@tonawanda-news.com
The Tonawanda News

Tonawanda News — A study released this month in honor of American Stroke Month shows more than one third of stroke patients don’t use an ambulance to get to the hospital, a trend Dr. Raquel Martin, the medical director of the Kenmore Mercy Hospital emergency department, said she found concerning.

When it comes to treat stroke, time is crucial, Martin said depending on the severity of the stroke, treatment should occur between three and six hours after it occurs. The longer it takes, the more permanent damage is done to the brain.

“Time is brain,” she said.

A study published April 30 in American Heart Association journal Circulation: Cardiovascular Quality and Outcomes determined 61 percent of people transported by ambulance got to the hospital within three hours of the first symptoms of a stroke, compared to 40 percent who didn’t use EMS.

“EMS are able to give the hospital a heads up, and that grabs the attention of the emergency room staff to be ready to act as soon as the patient arrives,” said Jeffrey L. Saver, M.D., senior author of the study and director of the UCLA Comprehensive Stroke Center in Los Angeles, Calif. “The ambulance crew also knows which hospitals in the area have qualified stroke centers. Patients don’t lose time going to one hospital only to be referred to another that can provide more advanced care if needed, whether that’s drugs to bust up the clot or device procedures to remove it.”

The New York state Department of Health designated stroke centers in Erie and Niagara counties include Erie County Medical Center, Global Vascular Institute, Kenmore Mercy Hospital, Mercy Hospital of Buffalo, Millard Fillmore Suburban Hospital, Sisters of Charity Hospital, Mount St. Marys Hospital and Healthcare, and Niagara Falls Memorial Medical Center, according to the department’s website.

Martin said local EMS personnel are trained to know the closest stroke center to a patient’s home and are in immediate contact with that hospital’s staff so that a bed and trained neurologists are available upon arrival, something that doesn’t necessarily happen if a stroke victim is brought in by a loved one.

“If you walk in you’ll have to wait to be triaged,” she said. “It’s cutting time off the front end.”

“Even if it’s two, three or five minutes it’s a matter of us getting a room clear and we can get things done,” she said, adding that even a matter of minutes can make all the difference in treating a stroke victim.

Martin said she thinks many patients don’t call 911 because they may not recognize their symptoms as being stroke-related, or they may be worried about the cost of an ambulance. 

“Sometimes they don’t want to bother the paramedics, or they think it could be a waste of time or they feel stupid,” she said. “Sometimes they say ‘Gosh, I don’t feel well, I’ll go to sleep and maybe feel better in the morning.’ That’s the worst thing you can do.”

Ultimately it’s better to waste everyone’s time than to not go to the hospital right away when you experience stroke symptoms, she said.

Key symptoms that could be a sign of stroke are face drooping or uneven smile, numbness or tingling in the face or limbs, and difficulties in speech or understanding language. Even if the symptoms go away soon, Martin said it could be a sign of a mini stroke and patients should still head to the emergency room.

“It could be a warning that you will have a major stroke,” Martin said. “I tell patients ‘That was God giving you a warning.’ ”

Contact Sunday Lifestyle editor Danielle Haynes at 693-1000, ext. 4116, or follow her on Twitter at @DanielleHaynes1.

SIGNS OF A STROKE F -- Face drooping, numbness, uneven smile A -- Arm weakness or numbness S -- Speech difficulty, slurring, lack of understanding T -- Time is of the essence, call 911 as soon as you notice any of the above symptoms, even if they seem to go away