Stroke Care – A Fight Against Time
Global has worked with various stroke care initiatives over the years, specifically on the Stroke Protocols and Guidelines throughout the province of BC.
The BC Stroke Strategy identified current “gaps” in stroke care and outlines key areas of focus. One of which, is necessary brain imaging. The current idea that there is a gap in brain imaging is also backed by a recent study in the American journal Stroke.
The study found less than 50 percent of stroke patients undergo necessary brain imaging within the recommended 25 minutes of their arrival at a hospital.
In stroke care, there is an ongoing battle against time. “Time is brain” goes the old stroke care mantra. With each minute that goes by, more and more brain cells are permanently lost. It is vital that individuals receive a timely diagnosis through brain imaging.
“We were struck by the fact that less than half of patients with acute stroke symptoms did not receive a brain scan within recommended guidelines,” says University of Rochester Medical Center neurologist Adam Kelly, lead author of the study.
“This was the performance of hospitals who are actively participating in a national quality improvement program, so rates in non-participating hospitals may be even worse.”
Why is brain imaging so important in stroke care? It allows physicians to “see” what is occurring in the brain. A diagnosis will determine what treatment options are available. For example, the physician may see that the clot can be tackled using clot-busting drugs. Unfortunately, clot-busting drugs often need to be administered as soon as possible and can lose effectiveness after a few hours.
The study also found that individuals were less likely to receive timely brain scans if they:
- Did not arrive at the hospital by ambulance (47 percent less likely)
- Had certain known risk factors for stroke such as diabetes, a prior history of stroke, over 75 years old, and peripheral vascular disease.
“Despite the strides that have been made in stroke care, it is clear that there is significant room for improvement in the evaluation of patients suspected of stroke,” says Kelly. “Time is too precious and hospitals cannot be the reason for delay.”
In our own backyard, stroke care has become an area of focus. Over the past five years, British Columbia has recognized the importance of stroke care and the related economic burden.
The Heart and Stroke Foundation in partnership with many organizations, including Global Medical Services, have come together to identify the gaps in stroke care and put in place a strategic direction for improving stroke care in BC.