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