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Specialized care improves stroke survival

If you are having a stroke, a stroke center may be the place to go.

When talking about stroke, doctors often say that “time is brain.” The faster you get medical help, the greater the chances of surviving and recovering from a stroke. A movement to establish special stroke centers across the country is ushering in a seemingly contradictory phrase: the old real estate adage “location, location, location.” The rise of stroke centers means that emergency medical crews could bypass a nearby hospital and take a few extra minutes to reach a more distant one.

In 2000, a group of stroke experts called the Brain Attack Coalition published guidelines for establishing primary stroke centers. Hospitals that meet the coalition’s standards of care are certified by the Joint Commission (a national nonprofit organization that evaluates health care facilities) in collaboration with the American Heart Association and the American Stroke Association. To date, more than 800 hospitals have been certified as primary stroke centers.

In theory, a hospital that has taken extra steps to provide the most up-to-date, evidence-based stroke care should do a better job than hospitals that haven’t done this. But does extra time spent getting to a stroke center pay off in the long run?

A study of almost 31,000 New York State residents treated for ischemic stroke (the type caused by a clot blocking a blood vessel in the brain) suggests that it does. Those who received care at a primary stroke center were 2.5% more likely to survive than those who received care at other hospitals. Of the 800,000 Americans who have strokes each year, about 140,000 die. What looks like a small reduction in deaths would translate into 3,500 lives saved each year (Journal of the American Medical Association, Jan. 26, 2011).

Stroke warning signs

Stroke has several telltale symptoms and warning signs. If you notice one or more of the signs below in yourself or someone else, or you’re worried that you or someone you are with is having a stroke, call 911 or your local emergency number right away:

  • onset of numbness or weakness of the face, arm, or leg, especially on one side of the body

  • confusion or trouble speaking or understanding

  • trouble seeing with one or both eyes

  • problems with walking, loss of balance, or coordination

  • inability to understand what someone is saying

  • sudden, severe headache with no known cause.

Plan ahead

Every minute counts when it comes to stroke. Planning ahead can help you get medical care faster. The most important thing you can do is become familiar with the warning signs of a stroke (see “Stroke warning signs”).

Second, put together an emergency list and keep it near the telephone or other prominent place. It should include information about whom to call in case of an emergency, your doctor’s phone number, and medications you are taking and those you are allergic to.

Also include the name and location of any primary stroke centers in your vicinity. You’re unlikely to find them listed in the Yellow Pages. Your best bet is to consult the official list published by the Joint Commission. You can search the commission’s database at www.health.harvard.edu/168. (Keep in mind that some large hospitals with highly regarded stroke units haven’t done the paperwork to get on the list.)

These precautions won’t stop a stroke or make it any less frightening and confusing. But they can save precious time — and brain.

Posted by: Dr.Health

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