Advocate Good Samaritan marks a stroke-care first — with an expert on speed dial
Imagine waking up with stroke symptoms and not knowing when they started. Panic may start to set in on your way to the hospital as you realize some treatments may be off the table.
Fortunately, this was recently addressed by updated medical guidance that allows hospitals to provide patients with an important clot busting treatment up to 24 hours after symptom onset. Advocate Good Samaritan Hospital in Downers Grove, Ill., treated its first patient under the new protocol in early June.
Tenecteplase (TNK) dissolves blood clots, which are the most common cause of ischemic stroke. The standard TNK treatment time frame was only 4.5 hours after symptom onset before the American Heart Association and American Stroke Association updated their guidance earlier this year.
“Administering TNK prevents the stroke from progressing and damaging more brain tissue,” explained Dr. Jason Day, a vascular neurologist and telestroke provider at Advocate Good Samaritan. “TNK’s ability to restore blood flow gives patients a higher chance of returning to normal functioning after stroke. The extended treatment window increases the number of patients who can receive this beneficial treatment.”
But not every patient is a candidate. There are only two ways a patient can qualify for thrombolysis in the extended treatment window.
“A patient is a candidate if their CT perfusion imaging confirms a large stroke hasn’t already occurred and that there is reduced blood flow that may cause tissue damage but could still benefit from thrombolysis,” Dr. Day said “A patient is also a candidate if MRI imaging shows a stroke occurring but no evidence of long-term damage yet. Usually only one imaging method is pursued.”
Even though the time frame of TNK administration has expanded, it’s still critically important that strokes are addressed as quickly as possible. That’s why Dr. Day’s role as a telestroke provider made the hospital’s first case extra special.
As the patient was wheeled in during triage, so was Dr. Day on a virtual device stand. He was able to quickly assess the patient’s symptoms, determine TNK candidacy, and explain associated risks.
“It’s proven that telestroke providers greatly reduce the time between patient arrival and TNK administration,” Dr. Day said. “Instead of paging the hospital’s neurology specialist whose attention might be on another patient, telestroke has a stroke expert on speed dial — ultimately improving patient outcomes.”
Speed is key inside and outside the hospital. Remember B.E. F.A.S.T. (Balance issues, Eyes/visual changes, Face drooping, Arm weakness, Speech difficulties, and Terrible headache) to help identify stroke symptoms in a timely manner.