Nearly 2 million brain cells die each minute a stroke goes untreated, increasing risk of permanent brain damage, disability or even death. That’s why it’s critical that a stroke is assessed immediately, so treatment can begin as soon as possible.
Earlier this year, the Comprehensive Stroke Center at MemorialCare Long Beach Medical Center opened a dedicated stroke treatment room in the Emergency Department. Upon a patient’s arrival, the team is ready to spring into action.
A neurologist specializes in strokes and treats disorders that affect the brain, spinal cord and nerves. Using telemedicine technology inside the room, a neurologist’s expertise is now available 24/7. The combination of telemedicine and a dedicated room ensures no time is wasted in diagnosing strokes – potentially saving millions of brain cells and the patient’s quality of life.
The dedicated stroke room has a “stroke cart” available, which includes a computer screen with a camera that allows a neurologist to assess a patient off site. The neurologist can control the camera and zoom into the patient to visualize his or her symptoms, while communicating with the onsite team to determine next steps.
“Our dedicated stroke room is one-of-a-kind,” says Angela West, MSN, RN, CCRN-K, ANVP, SCRN, program director, Comprehensive Stroke Center,
Long Beach Medical Center. “We realized that a dedicated room would speed up the entire screening and treatment process. Since we’ve opened the room, it’s done just that.”
Following a stroke assessment, the patient is taken just down the hall to the 320-slice computed tomography (CT) scanner to determine the areas of the brain that were affected in a matter of minutes. The stroke assessment/treatment room was strategically placed in an area that is close to the CT scan, shaving off minutes.
The CT scanner uses software that transfers a patient’s scans to an application on the neurologist’s iPhone or iPad. If not physically available, he or she uses the application to further evaluate the stroke and brain function by reviewing the patient’s vascular anatomy and blood flow.
From there, the neurologist determines if the patient is a candidate for the administration of a clot-busting intravenous medication, tissue plasminogen activator (tPA). For some patients tPA is not appropriate, or not enough, and a more complex intervention, such as a thrombectomy – a minimally invasive procedure to remove the clot from the brain during a cerebral angiogram – may be recommended to remove the clot.
Once the team decides on the best treatment option, the patient immediately receives tPA, undergoes a thrombectomy to remove the clot, or if more appropriate, receives both treatments.
When endovascularly removing a clot, the expert team from the Division of Interventional Neuroradiology (DINR), part of the Comprehensive Stroke Center, uses minimally-invasive techniques to remove it. If necessary, a stent can be placed into the blood vessel to help keep it open and prevent future strokes.
The collaboration between the University of California, Los Angeles (UCLA) trained DINR physicians make Long Beach Medical Center one of California’s most comprehensive hospitals for the diagnosis, treatment and rehabilitation of the most complicated strokes.