“On March 24, a little after 8 a.m., you sprang into action and I
am back after only four days at St. Joseph’s. I have no noticeable
effects from a stroke and I owed that to you and the North Memorial
team. Thank you and please continue your dedicated work”. –Maria P.
Perry
An A-typical
Morning
Maria Perry had just brewed her morning coffee on Thursday, March 24,
when her right arm began shaking violently as she lifted the pot. She
had steadied herself enough to put the pot back on the counter when her
right leg suddenly collapsed.
“After my leg gave out, I was pretty sure things were not okay. I
wondered if I was having a stroke, but I’m only 47 years old,” said
Perry, who works in customer service for Norwood & BIC in Sleepy
Eye.
“I sat on the floor for 20 minutes, unsure of what to do.”
Her only phone was in her bedroom, along with her husband, who slept
soundly through her calls for help. Eventually, Perry used the left side
of her body to pull herself up the stairs to get help.
“My husband asked if we should call 911 and I refused,” Perry
recalled, laughing. “I must not have been communicating well because my
husband knew better than to listen to me.”
CODE STROKE
When the ambulance arrived at Perry’s home minutes later, emergency
responders saw redness around Perry’s neck. This small signal prompted
them to test Perry’s nervous system by running a small instrument up the
bottom of her right foot. That response was all they needed to alert
Redwood Area Hospital’s emergency department that they were bringing
Perry in.
“When the emergency department receives a CODE STROKE call, we work
quickly because stroke is the leading cause of adult disability,”
explained Louise Anderson, RN, the acute care project coordinator who
oversees the hospital’s state-of-the-art Telestroke program. Through
video-conferencing technology, Telestroke brings a stroke physician into
the hospital’s emergency department 24 hours a day.
Redwood Area Hospital partners with Dr. Sandra Hanson, a stroke
neurologist at St. Joseph’s Hospital Certified Stroke Center in St.
Paul, Minn., which holds a gold seal of approval for stroke care by the
Joint Commission.
“By working with St. Joseph’s we are able to diagnose and treat
strokes within one hour of arrival, a critical time window to minimize
brain damage and disability,” Anderson said. “The time of symptom onset
is the biggest piece of information we need. By treating patients within
three hours of symptom onset, we can offer them the greatest
opportunity to minimize disability and maximize recovery.”
A Powerful Drug
Perry arrived in the emergency room about an hour after her symptoms
began. She received a short stroke screening and then underwent a CT
scan to examine the blood vessels in her brain.
Meanwhile, the stroke team, consisting of the ER physician, two
registered nurses, lab, radiology and the neurologist, interviewed
Perry’s family to gain more information about the events leading up to
her arrival.
“When we got to the hospital, it was almost a blur of activity,”
Perry recalled. “The doctor was on the video monitor and they were
running tests and diagnosing my stroke very quickly.”
Perry was diagnosed with an ischemic stroke, the most common type. It occurs when a blood clot blocks an artery to the brain.
Collaborating with St. Joseph’s, Redwood staff treated Perry with
tissue plasminogen activator, or tPA, a powerful medicine to break up
the clot.
“It is vital to have the neurologist on the monitor because they can
see things so detailed in their exam – even the pupils of the patient’s
eyes,” Anderson explained. “We also discuss other symptoms that
the patient may have had to be sure that it is safe for the patient to
receive the clot-busting drug.”
The team has had great success in treating ischemic strokes. From
2008 to 2011, the national average tPA treatment for patients arriving
with stroke symptoms was just 5 percent. At Redwood Area Hospital, 31
percent of patients with stroke symptoms were treated with tPA. The
other stroke patients did not receive the treatment because they were
diagnosed with another type of stroke, did not fit the optimal time
window from symptom onset, or had complications that wouldn’t allow for
the treatment.
“There’s often an attitude that rural healthcare is not the best
healthcare available.” Anderson said. ”Our rural hospital requires
cross training, strong teamwork, and networking to bring the best
possible care to our patients. That makes this program a success. All of
our physicians, nurses and area ambulance crews are trained to
recognize stroke symptoms and participate in the Telestroke program.”
A Changed Life
Just 45 minutes after arriving in the emergency room, Perry was
transferred by North Memorial helicopter to St. Paul. Less than an hour
later, the North Memorial team called Perry’s husband to let him know
they had arrived. Perry was prepped for a number of procedures at St.
Joseph’s to continue her stroke care, but an MRI showed the treatment
was not necessary. The tPA treatment had broken up her clot during the
helicopter ride.
“By the next morning I was up and moving and on my way to rehab,”
Perry said. “It really is amazing to see how this treatment changed the
outcome of my stroke. There were others at St. Joseph’s who were not as
lucky.”
She stayed at St. Joseph’s for four days before heading back home.
Perry now watches her cholesterol, has successfully given up smoking,
and takes aspirin and vitamins each day.
“I’ve learned now that time is vital when you have a stroke,” Perry
said. “Even at a young age, we should all be aware of stroke signs
because it really does make a difference when you seek treatment
quickly.”
Thanks to Redwood Area Hospital for sharing this story. © 2012 Redwood Area Hospital.