When Minutes Count, Count On Eisenhower's Stroke TeamBy: Roxanne Jones
“Stroke is not an accident. It’s an event that’s treatable and preventable,” says Eisenhower Medical Center Stroke Team Coordinator Deborah Bayer, RN, BSN. “And we are passionate about spreading this message.
”Eisenhower does more than talk about stroke prevention and treatment, however. As the first hospital in Riverside and San Bernardino counties to be designated a Certified Primary Stroke Center by The Joint Commission, Eisenhower has met rigorous national standards for stroke care. In fact, the hospital recently earned its second two-year certification, ensuring that when minutes count, you have close-to-home, around-the-clock access to a dedicated team of specialists with stroke-specific expertise who offer the latest, proven treatments.
“When people have chest pain, a symptom of a heart attack, they know they need to get to the hospital fast,” Bayer continues. “If a person has the warning signs of a stroke — a brain attack — it’s just as urgent to seek medical attention quickly [see sidebar to learn about stroke symptoms]. That’s because we have a narrow window of opportunity — just four and a half hours from the onset of stroke symptoms — in which we can administer medication or an intervention to treat it.”
Eisenhower’s Stroke Team, headed by Neurologist Hamid Salari-Namin, MD, comprises fellowship-trained interventional radiologists, hospitalists, nurse practitioners and emergency physicians — all trained to assess acute ischemic stroke, the most common type of stroke, caused by a blood clot that blocks blood flow to the brain. Together with state-of-the-art diagnostic technology, a full range of the most advanced treatments and integrated rehabilitation services, Eisenhower offers truly comprehensive stroke care.
“Our continuum of care is very thorough, starting with activation of the Stroke Team when someone presents to the Emergency Department with stroke symptoms,” Bayer explains. “All patients are quickly screened for their eligibility to receive intravenous tPA (tissue plasminogen activator), a powerful clot-busting medication. In some circumstances, the tPA can be administered directly to the clot via catheter [Eisenhower was the first in the Valley to offer intravenous tPA], which potentially extends the effective treatment time from four and a half to six hours for some patients. And in select cases, we can also use the Merci Retriever®,” she adds, referring to an innovative corkscrew-type device that mechanically removes blood clots from the brain in patients experiencing an ischemic stroke — the first device of its kind to receive FDA approval.
When these advanced treatments are given in time to appropriate patients, they can actually walk out of the hospital with little to no neurological deficits, Bayer notes. “It’s a miracle of medicine,” she says. “But it underscores why timing is so important,” she adds. “When a stroke happens, time is brain.” For stroke patients who require intensive care, Eisenhower has a dedicated critical care unit staffed by nurses with special stroke training.
“From there, we also have a stroke floor where staff is specially trained to care for patients coming out of intensive care,” Bayer says. “And for appropriate patients, we have the Valley’s newest and largest inpatient rehabilitation center which is delivering above-average outcomes for stroke patients (see related story on page 48).
“This breadth of expertise enables us to personalize our care approach for each patient’s unique needs,” she adds. Since being designated a Certified Primary Stroke Center, Eisenhower has treated more than 1,000 stroke patients, a testament to the Stroke Team’s depth of experience.
“This is definitely the place where I’d send family or come myself,” Bayer says. “I really believe in our program’s ability to provide high-quality, personalized and genuinely caring stroke care.”
Know the Wa rning Signs of Stroke
Eisenhower’s Stroke Team Coordinator Deborah Bayer, RN, BSN, urges everyone to remember the American Stroke Association’s “Act FAST!” guidelines for recognizing a stroke’s warning signs:
F – Facial droop on one side
A – Arm weakness
S – Speech impairment
T – Time (when did symptoms start)
“A lot of patients will experience weakness on one side of the body and go to bed, thinking it’ll get better overnight,” Bayer says. “But then we’ve missed that four and a half-hour window in which we can provide life-changing — or lifesaving — treatment. Instead, get up and get help,” she stresses. “Call 911 and allow us to provide care.”