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Race against the clock
01/13/2020
“In the same sense that time is muscle when it comes to heart attacks, time is brain when we’re talking about strokes,” says Eric Paulk, MD, medical director of the Tift Regional Medical Center Emergency Department. “The majority of strokes are what we call ischemic strokes, in which a clot stops blood flow to the brain, so every minute counts.”

One problem with starting treatment quickly is that many patients don’t realize they are experiencing a stroke in the first place. Stroke prevention and care rely on patient and family awareness of signs and symptoms, as well as fast recognition when the condition occurs.

“Stroke is significantly under recognized,”Dr. Paulk says. “The vast majority of people who have symptoms brush them off or delay telling anyone for hours. This can dramatically impact their treatment process, as well as their recovery.”


STROKE TREATMENT AT TRMC

“If you can pinpoint the exact time your stroke symptoms started, or if a witness knows, that can be invaluable to our emergency medicine staff when deciding on your course of treatment,” Dr. Paulk says.

Once the signs and symptoms of a stroke are recognized at TRMC, patients are immediately taken to have a computed tomography (CT) scan done. The purpose of the scan is to ensure there is no evidence of bleeding in the brain. TRMC, in partnership with the Medical College of Georgia, works with a neurologist via videoconferencing to assess the patient’s condition and determine whether acute therapy for stroke is necessary. After having the scan, blood work is drawn for the patient.

There is only one FDA-approved acute treatment for stroke—tissue plasminogen activator (tPA). In order to receive tPA, you must meet certain criteria. One of the most important requirements involved is time since the stroke began—tPA must be given within 4.5 hours, though many patients require it within 3 hours.

“Patients who are able to receive tPA are shown to have increased neurologic improvements and increased functional ability in the long-term,” Dr. Paulk says. “This could be the difference between being in a nursing home or being with your family. Don’t sit around and think it might get better. If you suspect you are experiencing stroke symptoms, call 911—don’t try to drive yourself or have a family member drive you. Prehospital personnel can begin life-saving procedures immediately.”


SPOT THE SIGNS

To make sure you and your loved ones can receive stroke treatment quickly, memorize the most common signs of stroke. Remember the acronym FAST, which stands for:
• Face—Are your facial muscles drooping on one side?
• Arms—Does one arm drift down when you raise them both?
• Speech—When you speak, are your words slurred?
• Time—If you observe any of the above symptoms, it’s time to call 911 immediately.