In anticipation of "Stroke Month" in May 2014 and our Educational Forum on "Stroke Prevention, Management Protocols and Rehabilitation",
on May 10th (1 - 3:30 pm in the Bay Club), the Resource Center featured during January 2014 the following Health Audio and Videos on Stroke:
Forum Focusing on Medical and Geographic Complexity of Stroke
May is “Stroke Awareness Month”. The Village Council's Health Committee has used this opportunity to schedule
its second Spring Forum, “Stroke: Prevention, Management Protocols and Rehabilitation,” for May 10 (1 p.m. at the Bay Club)
to discuss another health issue for which residents should be prepared even without any current symptoms or risks factors
(other than age). Our experience with stroke typically starts with a highly time-sensitive emergency and ends,
hopefully, with relatively few long-term repercussions for which rehabilitation may be needed.
Thus, it involves quite a few branches of the healthcare system as well as choices between organizations,
locations and modes and routes of transportation, especially since we happen to live in Port Ludlow.
Our forum will focus on what happens to the brain during and after a stroke and how to respond quickly
to minimize the debilitating consequences. Dr. David Tirschwell, co-director of the University of Washington’s
Stroke Center at Harborview, is our featured speaker covering risk factors, warning signs, early recognition
and treatment of different types of strokes. Panelists will then discuss what is happening before and during EMS transportation,
and at local hospitals, as well as under what circumstances Airlift NW may whisk us to Harborview or Swedish
(should we sign up with “Aircare” as insurance?). Attendees may also want to understand and compare the differences
in protocols for tele-stroke diagnosis, emergency treatments and monitoring of patients at or on the way to and from
the Jefferson ER (by neurologists at the Swedish Stroke Center) and Harrison Medical Center (by physicians at Harborview).
We may also be interested in how recent medical innovations and changes in hospital organizations may have affected various stroke protocols.
The forum organizers plan to have educational handouts available for all types and disease stages of stroke.
Residents are also encouraged to visit the stroke page on the Committee's website (plhealth.org/stroke.html)
for preparation and follow-up. Sign up sheets are posted at both clubs.
Parking space is limited. Car pooling is critical and much appreciated.
Know Stroke: Know the Signs. Act in Time [Brochure/Pamphlet]
Stroke is the third leading cause of death in the United States and a leading cause of serious,
long-term disability in adults. About 600,000 new strokes are reported in the U.S. each year.
The good news is that treatments are available that can greatly reduce the damage caused by a stroke.
However, you need to recognize the symptoms of a stroke and get to a hospital quickly.
Getting treatment within 60 minutes can prevent disability.
Brain Basics: Preventing Stroke [8pp.]
If you're like most Americans, you plan your future.
When you take a job, you examine its benefit plan. When you buy a home, you consider its location and condition so that your investment is safe.
Today, more and more Americans are protecting their most important asset—their brain. Are you?
Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association; Stroke. 2011;42:517-584; originally published online December 2, 2010.
This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke.Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia.... physical inactivity, and obesity and body fat distribution
"Stroke treatment is time-critical – the sooner a patient is treated, the better their chances of survival. Fast treatment can mean less
disability, too. For strokes caused by a blood clot in the brain (ischemic), clot-busting medication must be adminis-tered within
4.5 hours from the time they first have symptoms. For bleeding strokes (hemorrhagic), time is also critical. As an emergency
responder, you play a crucial role in getting patients to treatment in time.
2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
These guidelines deal with the acute diagnosis, stabilization, and acute medical and surgical treatments of acute ischemic stroke, as well as early inpatient management, secondary prevention, and complication management....The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation.
The purpose of the Stroke Triage and Destination Procedure is to help you identify stroke patients in the field so you can take them to the most appropriate hospital. Like trauma, stroke treatment is time-critical – the sooner a patient is treated, the better their chances of survival. Fast treatment can mean less disability, too. For strokes caused by a blood clot in the brain (ischemic), clot-busting medication must be adminis-tered within 4.5 hours from the time they first have symptoms. For bleeding strokes (hemorrhagic), time is also critical. As an emergency responder, you play a crucial role in getting patients to treatment in time.
Assess Applicability for Triage
Report from patient or bystander of one or more sudden:
Numbness or weakness of the face, arm or leg, especially on one side of the body Confusion, trouble speaking or understanding;
Trouble seeing in one or both eyes;
Trouble walking, dizziness, loss of balance or coordination;
Severe headache with no known cause.
Perform F.A.S.T. Assessment:
Face: unilateral facial droop?
Arms: unilateral drift or weakness?
Speech: abnormal or slurred?
Time last normal (determine time patient last known normal)
Yes to any one sign (Face, Arms, Speech) = YES
The Stroke Center and Telestroke: better care for the region
The UW Medicine Stroke Center at Harborview is unique to the Pacific Northwest; it includes six board-certified vascular neurologists, neuroradiologists, interventional neuroradiologists, neurosurgeons and rehabilitation specialists.
These individuals treat patients from the four-state WAMI region of Washington, Alaska, Montana and Idaho — in fact, they care for more than 700 patients hospitalized for stroke every year. Harborview has been recognized for this high level of care with certification as a Primary Stroke Center by The Joint Commission, stroke honor roll recognition by the American Heart Association/American Stroke Association and pending state certification as a level 1 stroke center.
Harborview Medical Center named to Target: Stroke Honor Roll by Clare Hagerty,
UW Today; 2010-12-14 [FROM THE UW NEWS ARCHIVES PRIOR TO 2011]
The UW Medicine Stroke Center at Harborview has been recognized for excellence in emergency stroke care on the Target: Stroke Honor Roll by the American Heart Association / American Stroke Association. Harborview is one of a select group of hospitals in the U.S. -- and the first in Washington -- to make the list.
UW Medicine: Stroke referrals and TeleStroke partnership program
"Why do our communities need TeleStroke?
With TeleStroke, consulting partners receive immediate telephone consultation with a vascular neurologist.
The specialist can review the patient’s digital radiology images via a virtual private network and provide immediate
feedback to the physician requesting consultation. Referring partners also have access to acute stroke evaluation
at UW Medicine, as well as diagnostic and treatment protocols to facilitate each patient’s treatment.
To request a TeleStroke consult, please contact the
UW Medicine Transfer Center
According to a letter from the Harrison Foundation (Nov 14, 2011), Harrison Medical Center is now a member of this partnership.
Press Release: Harrison Medical Center:
"Harrison's stroke program recognized for outstanding care"- 1/4/2012
[Program dedicated to positive outcomes for stroke patients; incl. Partnershipwith UW & Harborview]
Harrison Medical Center/University of Washington-Harborview Medical Center’s Partnership
[Harrison Press Release
"Harrison's stroke program recognized for outstanding care", January 4, 2012] "Harrison partners with Harborview
Medical Center’s Telestroke Program to allow 24/7 consultation with a vascular neurologist and access to University
of Washington stroke experts. Along with real-time consultation, the organizations share education and research as
well as evidence-based clinical protocols and practice guidelines to ensure constant innovation in care..... Harrison’s
coordinated approach to stroke care earned the Medical Center the American Stroke Association's Get With The
Guidelines-Stroke Bronze Performance Achievement Award. The award recognizes Harrison’s commitment
and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment
according to nationally accepted standards and recommendations."
Swedish Telestroke Team(s)
There are several Swedish Acute Stroke Telemedicine Teams, so one of them is always available – around the clock every day of the year – to support emergency departments throughout Washington.
Murdock Grant & Educational Series
Swedish Medical Center received a grant from the M.J. Murdock Charitable Trust to implement stroke telemedicine partnerships with four small/rural hospitals in Washington State. As part of this grant, we are pleased to offer online TeleCME Stroke educational programs. The Department of Health passed legislation in 2009 for the development and implementation of a Stroke System of Care for Washington State. The Stroke System of Care requires hospitals to designate their capabilities and if the hospital decides to participate, staff must complete stroke annual education. This series serves that purpose.
Jefferson Healthcare Is Ahead of the Curve in
Emergency Cardiac and Stroke Care [Jefferson HC Newsletter, Autumn 2010, p.8]
"Jefferson Healthcare was the first hospital on the Olympic Peninsula
to partner with Swedish Medical Center for stroke care. Now, under
the new Emergency Cardiac and Stroke Care law (SSHB 2396),
Jefferson Healthcare will qualify as a level III stroke facility and a
level IV cardiac care facility. The law will allow Jefferson Healthcare
to voluntarily self-identify its cardiac and stroke capabilities and
designations, as of January 2011."
Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient: A Scientific Statement From the American Heart Association, Stroke. 2010;41:2402-2448; originally published online September 2, 2010
"[....] Notwithstanding the substantial progress in acute stroke
care over the past 15 years, the focus of stroke medical
advances and healthcare resources has been on acute and
subacute recovery phases, which has resulted in substantial
health disparities in later phases of stroke care...."
"Cognitive Coach Describes a Journey with a Special Client" by R. Rose Simon, MA, Certified Journal Instructor
PL Voice, June 2013 , scroll to pp.4-5
"In America at the moment, there isn’t a name for the work
I do. I am neither a speech pathologist nor a caregiver.
I just call myself a cognitive coach or “brain buddy.”
In Australia, Canada and the UK, the people who work
with stroke survivors, doing similar work to what I am
doing, are called communication partners, mentors and
“befrienders.” This describes a new type of support
worker that offers a lifeline to people with aphasia, which
encompasses problems with speaking and understanding
following a stroke. [.....] "
NeuroLogica Corp. [article in BusinessWeek.com, July 2014]
was founded in 2004 and is headquartered in Danvers, Massachusetts. As of January 28, 2013, NeuroLogica Corp. operates as a subsidiary of Samsung Electronics America, Inc.
UTHealth introduces nation’s first Mobile Stroke Unit
“It typically takes roughly an hour once a stroke patient arrives in the emergency room to receive treatment. So if we can actually
put the emergency room in the ambulance and take the CT scanner to the patient, we could treat the patient at the scene with the
medication and save that hour,” said James C. Grotta, M.D., director of stroke research in the Clinical Institute for Research &
Innovation at Memorial Hermann-TMC .... “That hour could mean saving 120 million brain cells..
After observing a similar unit in Germany, Grotta....had the opportunity to present his idea to UTHealth Development Board members.
He was pleasantly surprised when a couple approached him and offered to help with the project...
Ambulance with mobile CT cuts stroke treatment times
By Eric Barnes, AuntMinnie.com staff writer
April 23, 2014 -- An ambulance equipped with a mobile CT scanner and thrombolysis equipment reduced treatment times for stroke patients without a corresponding increase in adverse events, according to a study published by German researchers in the Journal of the American Medical Association. .... use of the specialized Stroke Emergency Mobile (STEMO) ambulance cut the average alarm-to-treatment period for patients with suspected stroke by about 25 minutes
"Act in Time:
Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people’s lives and enhance their chances for successful recovery."
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