Quicker, Quality Stroke Care Changing Lives

March 30, 2018
strokevictim

Karen Z, 68, is a stroke victim who considers herself very lucky and yet whose life will never be the same.

She represents 10 percent of the victims who recover completely from a stroke without any signs of deficits.

Thanks to an ongoing collaboration between Memorial and local fire-rescue departments, Karen will resume her summer teaching profession in Canada after she leaves her seasonal home in Hallandale Beach in the spring.

Ever grateful to continue life as normal, Karen wanted to personally meet and thank the individuals responsible for saving her life.

Little did she know that the meet and greet she had scheduled and envisioned would turn into quite the educational experience and much more.

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As she arrived with edible treats to the Hallandale Beach Fire-Rescue station, she was met by Memorial Neuroscience Institute physicians and staff and the first responders who made it possible for her to walk out of the hospital without visible signs of a stroke.

There, she learned how Memorial's partnership with the Hallandale Beach Fire-Rescue  is helping stroke victims get quicker care in South Florida.

Karen was unaware that she was experiencing stroke-like symptoms while driving one evening. The next morning, she experienced weakness on the right side of her body and had trouble with her speech. Neighbors found her paralyzed on the floor and called first responders.

“I remember weakness,” she explained to the team at the station. “I remember having a fuzzy vision and then the next morning I couldn’t move my right arm nor see out of the right side. I didn’t even know I was having a stroke.”   

Fire Rescue promptly evaluated her at her home and called a pre-hospital stroke alert to Memorial Regional. The Hallandale first responders then used FaceTime to communicate with the Memorial NeuroInterventional Care team to assess during the ride to the hospital.

“The hospital is reacting to our call on the field,” said Hallandale Beach Fire-Rescue Chief Mark Ellis. “We are working in parallel instead of them having to wait till our (first responders) process is finished for them to begin theirs (stroke team). we are working together from the moment we get to the patient and that has saved a lot of time and lives.”

The Neuro Interventional team including Dr. Brijesh Mehta, Medical Director of Stroke and Neurocritical Care, was alerted. The Cath Lab was activated prior to patient’s arrival to the emergency room based on patient’s severity of neurological impairment. A diagnostic imaging of her brain at Memorial Regional Hospital demonstrated blockage of the left internal carotid artery. She was taken to the Cath Lab for mechanical thrombectomy.

“We are in a whole new area in our field for acute stroke care,” said Mehta. “Just a couple of years ago this new technology proven scientifically now allows us to open up these arteries that otherwise would have remained permanently blocked and kept the patient disabled.”

Because of the prehospital alert by Hallandale first responders and early activation of the Cath Lab team, door to arterial puncture time was 35 minutes and the carotid artery was opened up within 60 minutes of Karen’s arrival to the hospital. She experienced immediate neurological improvement and was able to lift her right arm and right leg without any difficulty while still on the Cath Lab table.

She is now completely back to normal because of the efficiency in care provided by the Hallandale crew and the rapid in-hospital parallel workflow with Memorial Regional Hospital.

 “From the people who pick you up, to the people who operate on you, to the people who take care of you afterward – it works like clockwork,” said Karen. “It’s absolutely amazing.”
Statistics from the National Stroke Association reveal that 40 percent of stroke victims experience moderate to severe impairments and deficits that require special care versus 25 percent who recover with minor impairments needing rehabilitation.

By enhancing EMS stroke recognition, developing adequate pre-hospital care that included the use of Facetime for early assessment of patients to screen for potential larges vessel stroke, and working with new technologies in acute stroke care, studies show lower mortality and reduced long-term disability.

“Time is brain. Every 30 minute delay decreases likelihood of good outcomes by 14-16%,” said Mehta. “Through partnerships like the one shared by our Memorial’s stroke team and local first responders like Hallandale Fire-Rescue, best outcomes are ensured.”