A NEW STROKE TREATMENT PROTOCOL BRINGS CAT SCANS AND CLOT BUSTING MEDICATION DIRECTLY TO BROOKLYNITES
BY EVAN MONROE
According to statistics released in May by the U.S. Centers for Disease Control and Prevention, stroke is now the fifth leading cause of death in America, and the single leading cause of serious long term disability. In 2017, just under 800,000 people suffered from this medical incident (610,000 are first attacks, while 185,000 are recurrent) defined as the interruption of blood flow to an area of the brain and 85% of such events are described as ischemic in nature, which means the interruption is caused by a blood clot.
Rapid response to stroke is particularly vital, and traditionally, treatment begins with an ambulance ride to a hospital, where a CAT scan is performed. In a recent and first of its kind approach on the East Coast, however, New York Presbyterian, in partnership with Weill Cornell Medicine, is bringing treatment procedures directly to patients. Its Mobile Stroke Treatment Unit, deployed via the FDNY through the city’s 911 system, looks like a typical ambulance, but is staffed by a specialized team of para medics from the Regional Emergency Medical Services Council of New York City, a computed tomography (CT) technologist, and an RN specially trained for stroke care all communicating with a board certified neurologist who performs a consultation remotely. The program rolled out in Manhattan, but has been recently expanded to include units from New York Presbyterian Brooklyn Methodist Hospital and from New York Presbyterian Queens.
“We can CAT scan right here in the ambulance in front of someone’s house and have all the medications that an ER would have,” explained New York Presbyterian paramedic Ellen Troudt.
Neurologist David Roh, MD, explained that the principal ischemic stroke treatment is “a medication called TPA, which is a very strong blood clot buster, but can only be administered within a certain period of time after the stroke [three hours, according to the American Stroke Association]. Any delay equals millions of neurons lost, so saving 20 minutes of transport time can make a tremendous difference.”
Part of the analysis of the new treatment program will consist of assessing patient outcomes at 90 days comparing those who utilized it versus those brought to the hospital through traditional EMS units, but initial results are highly encouraging.
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