By Karen Gorby
Chief Executive Officer/Chief Nursing Officer, Angel Medical Center
I’m devoting this month’s column to the topic of stroke – a serious health issue that strikes many in our community and close to 800,000 Americans annually. It’s a leading cause of adult disability, and its aftereffects profoundly shape quality of life. We at Angel Medical Center (AMC) not only treat stroke patients and offer rehabilitation services to stroke survivors, we want to help the community at large learn what they can do lower their stroke risk.
I’m proud that AMC was certified for the first time as an Acute Stroke Ready Hospital in 2016 by The Joint Commission and the American Stroke Association/American Heart Association. We were the first North Carolina hospital to receive the certification, which lasts for two years. Recertified last year, we continue to strive to do everything the recognition connotes: Our staff includes clinicians specifically trained to treat stroke patients, our technology allows us to perform stroke diagnostic testing, we can link our clinicians to neurologists at Mission Hospital via telemedicine and we can administer the lifesaving clot-busting drug alteplase to patients who need it. If a patient’s emergent needs require that they be flown to Mission Hospital, we’re prepared for that, too.
Cara Smith is AMC’s Acute Stroke Ready Hospital Program Leader and has much to share with the community about stroke – how to spot it, available innovative treatments and how to prevent it. “I’m invested in telling the community how to identify the signs and symptoms of stroke by using this easy-to-remember acronym: BEFAST. It stands for the following:
- B – balance problems
- E – eyes, or blurred vision or vision loss
- F – facial drooping
- A – arm or leg strength/movement problems
- S – speech difficulty
- T – time to call 911
If you can remember BEFAST and notice any of these symptoms, you’ll be able to help the patient as soon as possible, and that’s critical,” declares Smith. She adds that time is brain, meaning that the sooner a person can be treated for stroke, the fewer brains cells that will be damaged.
With that 911 call, stroke treatment starts in our community with our Macon County EMS partners, who work in tandem with us to diagnose stroke while in the field. Their communication allows us to be ready to receive the patient and perform a CAT scan.
“In 2018, AMC treated 146 patients for stroke – 89 patients had ischemic strokes – the most common type where a blood clot forms in the brain, 50 had transient ischemic stroke, otherwise known as a mini-stroke (where the clot creates a temporary blockage) and 7 were treated for hemorrhagic stroke, or a stroke caused by a weak blood vessel that ruptures and bleeds into the surrounding brain tissue,” explains Smith. The good news, she shares, is that ischemic stroke symptoms can be treated with the revolutionary clot-busting drug alteplase up to 4.5 hours after the stroke’s onset. If treated within this time frame, symptoms can be reduced or even eliminated.
Smith notes that the biggest change in stroke treatment came in 2018 with the expansion of the treatment window to 24 hours from time of onset for select cases. Mission, along with AMC, introduced RAPID software, which can study ischemic stroke patient scan data and pinpoint the brain tissue that’s salvageable within this 24-hour window. Patients can then be successfully treated with a clot retrieval intervention. “This discovery has radically changed stroke patients’ lives,” declares Smith. If our patient needs this treatment, we facilitate their transfer to Mission Hospital within 60 minutes, via the MAMA helicopter. Mission was one of the first health systems in the nation to subscribe to the new expanded treatment window.
Smith wants the community to know that AMC has a robust rehabilitation services team of occupational therapists, physical therapists and speech therapists who help stroke patients regain their strength and skills. “AMC also offers a stroke support group the first Wednesday of every month where stroke survivors can get emotional support from each other, share experiences and listen to a wide range of educational speakers,” says Smith.
The message Smith most urgently wants to convey to the community is that calling 911 is always the right thing to do if one experiences any suspicious symptoms or is with someone who exhibits symptoms. She also emphasizes that there are plenty of healthy lifestyle practices community members can practice to lower their stroke risk, including keeping their blood pressure and weight down via healthy eating, exercise and stress reduction techniques like meditation and yoga.
AMC supports our community in their efforts to prevent stroke and is here to diagnose and treat patients who experience a stroke, as well as help patients with their long-term recovery.
Karen S. Gorby, RN, MSN, MBA, CENP, FACHE, is Chief Executive Officer and Chief Nursing Officer of Angel Medical Center. Gorby is a Fellow of the American College of Healthcare Executives (ACHE). For nearly three decades, she has served hospitals and health systems in Ohio before assuming her role at Angel Medical Center. Gorby received her MSN from Saint Joseph’s College in Standish, Maine, and her MBA from Wright State University in Fairborn, Ohio.