X-Message-Number: 23210
Date: Fri, 2 Jan 2004 16:39:13 -0800 (PST)
From: Christine Gaspar <>
Subject: regarding strokes

--0-1598841310-1073090353=:92745


Hi there. I wanted to mention a protocol in place at our hospital, and others 
too. Its called the  "Acute Stroke Protocol"
 

It goes something like this...if a person presents with an acute stroke, a set 
of rapid

measures are put into play. The timing of the onset of stroke symptoms is 
essential- 

there must be certainty...for example a person sitting at the supper table all 
of a sudden 

collapsing, witnessed, rather than waking up in the am with stroke symptoms (not
being 
sure what time the symptoms started) The window is 3 hours...
 

The person arrives in the ER, is rapidly assessed, ER MD called STAT to assess. 
If the 

person has no risk factors for bleeding, such as recent surgery, or brain 
tumour, or 

whatever, they are sent for a STAT head CT, to ensure that the stroke is 
occlusive rather 

than hemorrhagic.The CT must be evaluated by a neurologist who can then order a

thrombolytic drug- TPa or TNK- I cannot recall which, sorry. If the window 
between the 

onset of symptoms and time to administer the drug is within 3 hours, it is done.
I have 

personally been involved in 2 such cases- and in one, the lady presented 
completely 

aphasic (non verbal), with profound right sided weakness. She would have 
literally been a 

vegetable. The drug was given, and within 2 hours, was sitting up talking with 
her family- 

no residual damage. The clot had been dissolved, and her stroke completely 
resolved. 

Mind you, because this protocol is in place, there is rapid communication 
between the 

ER staff, the neurologist on call, and radiology...that case took place on the 
night shift, 

and there was no delay even though the neurologist and radiologist were in their
homes 

when the patient arrived. It is amazing when it works, and every hospital should
implement this protocol.
Happy New Year,
Christine Gaspar

Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=23210