What it Means to be a Joint Commission Certified Comprehensive Stroke Center

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Stroke

A stroke is a frightening medical emergency, and while several area hospitals are equipped to deal with some aspects of it, MemorialCare Long Beach Medical Center offers the highest level of care and expertise in treating strokes.

Long Beach Medical Center is a Joint Commission Certified Comprehensive Stroke Center, which means it has specialists available 24/7 for immediate care, diagnosis, treatment and follow-up rehabilitation for all types of stroke.

As only the 3rd hospital in Los Angeles County to earn this designation, it has specialists around the clock who can treat the full range of cases.

“The center treats 900 stroke patients each year,” says Angie West, RN, MSN, CCRN, director, Comprehensive Stroke Center, Long Beach Medical Center.

The most common type of stroke is caused by a clot that blocks an artery from supplying blood to the brain. It can occur in the larger arteries of the brain, or in smaller, deeper vessels.

A hemorrhagic stroke occurs when a weakened blood vessel breaks and bleeds. While en route to the hospital, paramedics can assess a victim’s stroke type and seriousness by observing symptoms such as facial droop, arm movement and grip strength.

“If the symptoms are serious enough to suggest a blood clot in a large brain artery, the ambulance will head to the nearest certified comprehensive stroke center,” West said. “We don’t have time to waste. Everything is time-sensitive, especially during the first 24 hours. From the first signs of a stroke, the brain can lose two million neurons each minute.”

Death of neurons, or nerve cells, can mean loss of speech, vision, memory and the ability to move arms and legs. Getting the right treatment in time will mean these losses may be decreased or even reversed. If too many hours pass, the damage is permanent.

When a stroke patient arrives, a specially trained team will be waiting for them in the ED. They may be able to administer an anticlotting medication, give medications to control blood pressure, provide interventions to remove the clot or to decrease bleeding; depending on the type of stroke.

Specialists, which include the Division of Interventional Neuroradiology (DINR) in partnership with UCLA, stroke neurologists, neurosurgeons and neuroradiologists, all work together to provide the best possible care. When arriving in the ED, a CT scan is done immediately upon arrival to identify the type of stroke.

For an acute ischemic stroke, a CT angiogram and a CT perfusion scan is done to show where the clot is located. The neurologists and DINR team then quickly discuss the best treatment options.

“Many clots can be removed by thrombectomy, in which the doctors use the groin-inserted catheter to reach in and pull the clot out,” says West.

“For a cerebral aneurysm, our team of neurosurgeons and the DINR team consult to decide the best way to secure the aneurysm; by performing an open craniotomy to clip the aneurysm or through an angiogram to coil the aneurysm.”

“All of this needs to be done very quickly,” she said. “And we have amazing physicians. Patients are then moved to a neuro intensive care unit (ICU) for care. The neuro ICU is staffed with specially trained RNs, therapists, registered dietitians, respiratory care practitioners, and case managers to get stabilized. Once stable, we try to get our patients to our acute rehabilitation center for improved recovery.”

“The best thing is to avoid having a stroke,” West said. “But if it happens, don’t delay. Call 911.”