Opinion: If Having Stroke Symptoms, Get to ER Quickly
My mother, who is 81 and in good health, woke up early one morning, and when she stood, her left leg felt numb. She had difficulty walking and the leg felt heavy. Always the optimist, she felt if she just rested, her leg would feel better. But it didn’t get better. She kept walking on it, and several hours later, she fell. That was when she called the ambulance.
By the time she got to the hospital, it had been about six hours since her symptoms started. The “window of opportunity” — three to four and a half hours — for treatment with clot-busting drugs which could reduce or stop damage from the stroke was past.
Although she recovered and went through rehab with flying colors, my mother still has some weakness in the left side, which causes difficulty walking. She is active, but not to the extent she was before her stroke.
Situation Is Common
My mother’s story is, unfortunately, all too common. The American Heart Association reports in a new study that more than a third of people who have a stroke don’t go to the hospital by ambulance, which saves precious time. And time is of the utmost importance when it comes to stroke.
When looking at the records of more than 204,000 people arriving at emergency rooms from 2003-2010, emergency medical services (EMS) transported 63.7 percent who had experienced a stroke.
EMS transported 79 percent of people who got to the hospital within two hours of having stroke symptoms. As a result, they had quicker evaluation, and faster treatment, which is critical after a stroke in order to prevent lasting problems.
These are other findings from the study:
- Almost 61 percent of people transported by EMS got to the hospital within three hours of the first symptoms, compared to 40 percent who didn’t use EMS.
- Almost 55 percent using EMS had a brain scan within 25 minutes of hospital arrival, compared to 35.6 percent who didn’t use EMS. (A brain scan is used to detect whether a stroke has occurred.)
- Of patients eligible for treatment with a clot-busting drug, 67.3 percent using EMS received it within three hours of when symptoms started, compared to 44.1 percent who didn’t use EMS. (Clot-busting drugs can be given to dissolve a clot in the brain and reduce or eliminate stroke symptoms.)
“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. “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.”
Some People Don’t Know Symptoms
James Ekundayo, M.D., Dr.P.H., lead author of the study and assistant professor in the Department of Family and Community Medicine at Meharry Medical College in Nashville, TN, says “people may be reluctant to call EMS because they may not recognize stroke symptoms.”
“We hear people say they just didn’t want to be a bother, but many times there could have been a better outcome if EMS had been called,” he said.
Stroke is the third leading cause of death in the United States. About 795,000 people experience a new or recurrent stroke each year — which is a stroke every 40 seconds or a related death every four minutes. Most strokes are either ischemic, meaning they are caused by a clot in the brain, or hemorrhagic, meaning they are caused by a burst blood vessel in the brain. Only ischemic strokes are treated with clot-buster drugs.
The AHA has a program called “FAST” to help people recognize signs of a stroke:
- Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile.
- Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- Speech Difficulty – Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
- Time to call 9-1-1 – If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.
“Your life, your brain, depends on calling 9-1-1,” Saver said. “Know the signs and act fast if you or someone you’re with is having stroke symptoms.”
For more information, go to the American Stroke Association website.