State should update emergency protocols for strokes

34

Every year in Michigan, thousands of lives are impacted by stroke. In 2019 alone, we lost 5,200 fellow Michiganders to stroke. It can touch any of us and our families, friends and colleagues.

During Stroke Awareness Month, we honor and remember those we have lost to stroke. We also recognize family members and caregivers for the incredible work they do in caring for patients living with disabilities after surviving a stroke.

As a physician who regularly treats stroke patients, I can attest to the life-changing impact this illness has on so many individuals. Yet, I am encouraged by the on-going medical innovations that are making it possible for more people to survive, then thrive, following a stroke. This includes a minimally invasive procedure known as mechanical thrombectomy — or endovascular therapy — which is performed by highly experienced neurointerventional care teams at Level 1 stroke centers such as Spectrum Health Butterworth Hospital, where I practice. (The centers where mechanical thrombectomy is performed also are known as comprehensive and thrombectomy-capable stroke centers.) Through this procedure, my colleagues and I can quickly locate and extract the clot responsible for the stroke and restore blood flow to the patient’s brain.

This procedure has revolutionized treatment for critical cases of stroke, including emergent large vessel occlusion (ELVO) — the most severe form of ischemic stroke. Provided patients who would benefit from this procedure are triaged and immediately transported directly to the hospitals equipped to perform it, endovascular therapy is saving lives.

In correlation with the latest in medical innovation, several states across the country have updated their stroke systems of care to reflect the trauma system. Just as a critically injured patient is transported by EMS to a Level 1 trauma center, these states — including our neighbor, Ohio — have adopted a system to ensure a critical stroke patient is transported directly to a Level 1 stroke center for lifesaving care. Research has found that for every 10 minutes saved in accessing treatment, critical stroke patients experience an additional month of life without disability.

The latest National Model EMS Clinical Guidelines that were just released this spring also recognize the unique, time-sensitive needs of critical stroke patients presenting with ELVO. Included within these guidelines is a recommendation that EMS consider transporting a patient with a suspected ELVO to a “hospital capable of mechanical thrombectomy” based on the local EMS stroke plan.

In support of this nationwide effort to improve triage and transport protocols for stroke, I encourage Michigan’s health officials and leaders to consider similar changes adopted by states such as Ohio and included within the national EMS guidelines. In honor of Stroke Awareness Month, let’s work together to bridge the gap that exists in our state between lifesaving treatment for stroke patients by updating emergency protocols to ensure timely access to the optimal stroke care for our fellow Michiganders. 

Dr. Jenny Tsai is a board-certified interventional and vascular neurologist practicing at Spectrum Health in Grand Rapids. She also is a member of the Society of NeuroInterventional Surgery and its board of directors, supporting its Get Ahead of Stroke campaign to improve systems of care for stroke patients.

Facebook Comments