Take the Ambulance, Not Your Car

Robert W. Griffith, MD

A new report from the Centers for Disease Control and Prevention - the CDC - describes the pre-hospital and hospital delays between stroke onset and starting treatment. This period is critical. Tissue plasminogen activator (t-PA) therapy , if instituted within 3 hours, can have a dramatic effect on survival and recovery in ischemic (i.e. thrombotic) stroke. The sooner tPA is given, the better the result. However, brain imaging is usually needed first, to exclude the hemorrhagic type of stroke. Obviously, both pre-hospital delay (deciding if it's necessary to go to the hospital), journey time (private car or ambulance?), and in-hospital delay (time to imaging and starting treatment) are crucial, and one should do one's best to make them as short as possible.

First, one should know the warning signs of stroke: Sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden, severe headache with no obvious cause.

Next, call the ambulance - 911. Over 69% of those who arrived at the hospital by ambulance received brain imaging within one hour, compared with 56% who came by car. (This is likely because the ambulance bypasses the triage entrance to the ER.)

Third - make sure your local hospital is aware of the need for speed, The use of coordinated ambulance services that include advance notification to receiving hospitals can help shorten the time to brain imaging, and hence the start of treatment.

Fourth, make sure your significant other or close family know the warning signs and the need to call 911 in a timely fashion - just in case you can't communicate clearly.

Source
HealthandAge Blog

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