Time is of the Essence When Dealing with Stroke
By Vanessa Orr

Stroke is the third leading cause of death in women, and the fifth leading cause of death in men, and yet many people don't recognize the symptoms of stroke when they happen. "I can't stress enough that if a person feels like there is something wrong, they need to get to a hospital right away," explained Toni Behanna, Stroke Coordinator, Washington Health System. "Many people just lie down and hope that it will go away, but getting to the hospital quickly can make a huge difference in improving outcomes."

Stroke is more prevalent in women than in men, with 60 percent of cases happening in female patients, and the majority of strokes take place in people over age 65. A stroke occurs when a blockage—either a blood clot or a piece of plaque—either temporarily blocks a blood vessel or causes it to burst. Some strokes can be caused by heredity, as well as by modifiable risk factors such as diet, smoking and hypertension.

According to the American Heart Association/American Stroke Association, stroke is the number four cause of death and a leading cause of adult disability in the United States. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year.

The best way to determine if a person is having a stroke is through a FAST (face, arms, speech and time) assessment.

Face—Check to see if one side of the person's face is drooping, or if one side of their lips stays down when they are smiling. Someone having a stroke also can't raise his or her eyebrows.

Arms—One arm works while the other doesn't, or the person feels weakness or numbness in the arms.

Speech—The person has trouble getting words out, or speech is garbled. They may also have problems understanding someone else speaking.

Time—If any of these symptoms are present, get the person to the hospital right away.

According to Behanna, time is of the essence in the case of stroke. "A stroke can be reversed if a person is treated right away," she explained. "In some people, all of the symptoms completely resolve, and in others, the symptoms partially resolve—it all depends on the person and how soon they get treatment."

Patients can be treated with the drug TPA, though not all patients are able to receive it. Patients need to be evaluated before the drug is given, and it can be administered up to four-and-a-half hours after the onset of symptoms. "Because we are a primary stroke center, we can administer TPA," said Behanna. "If the person reaches us after the window has closed for administering the drug, there are other options that are available such as a mechanical procedure to unblock the blood vessel."

In addition to being designated as a primary stroke center certified through the Joint Commission, Washington Health System was also recently honored with the Get With The Guidelines®—Stroke Gold Plus Quality Achievement Award for implementing specific quality improvement measures outlined by the American heart Association/American Stroke Association for the treatment of stroke patients. This is the fourth year in a row that the health system has received this award at the Gold Plus level.

"This award demonstrates our hospital's commitment to ensuring that our patients receive care based on internationally respected clinical guidelines," said Behanna.

Washington Health System earned the award by meeting specific quality achievement measures for the rapid diagnosis and treatment of stroke patients, including aggressive use of medications and risk-reduction therapies. The hospital's staff also implements prevention measures, including educating stroke patients to manage their risk factors and to be aware of warning signs for stroke, and ensuring that they take their medications properly.

For more information on Washington Health System's stroke program, contact Toni Behanna at (724) 223-3261 or tbehanna@whs.org or visit www.whs.org.

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