WESTFIELD–Baystate Noble Hospital has received an award from the American Heart Association for excellence in stroke care.
The hospital received the “silver plus achievement” in the “Get With the Guidelines” program, which is given to hospitals who have met goals within the program for treating possible stroke victims for 12 consecutive months. The achievement is one of three that hospitals can receive, with the others being bronze for 90 consecutive days and gold for 24 consecutive months.
“What this is in sort of broad terms, there are American Heart Association guidelines of how stroke patients should be treated,” Dr. Thomas Higgins, chief medical officer of Baystate Noble, said. “This demonstrates to the community that we can keep care local and people can get as good care as they can at a big medical center.”
Dr. Thomas Higgins
According to the Heart Association website, “Get With the Guidelines” is “an in-hospital program for improving stroke care by promoting consistent adherence to the latest scientific treatment guidelines.”
The program seeks to promote optimal care for possible stroke patients and sets guidelines from time of recognition of symptoms to follow-up examinations. This includes a series of steps for patients who may be having an ischemic stroke and are candidates to receive the clot-busting drug “tissue plasminogen activator,” or tPA.
The first step is to recognize symptoms early, Higgins said. This can be due to public education and awareness, or by emergency personnel like EMTs and paramedics who are trained to recognize symptoms of a possible stroke.
“It’s incredibly important to know it probably won’t go away,” Higgins said of the symptoms that people may ignore.
“Time is brain–it’s a situation that if a half hour goes by the success rate is higher than if you wait until the last minute,” he said.
Once the possible stroke is recognized, which may include facial drooping, arm weakness or garbled speech, the patient must be at the hospital within two hours of symptoms starting and must also receive a CAT scan.
The CAT scan is important to diagnose what kind of stroke, if any, is happening. An ischemic stroke can receive the clot-busting medication and potentially save a life, but in a different kind of stroke called a “hemorrhagic stroke,” the tPA could cause further bleeding.
If it is within that two-hour window and the type of stroke diagnosed is ischemic, along with other guidelines that are put in place, then the stroke victim may receive tPA, which is another step in the guidelines.
Then, Higgins said, additional steps are taken, including checking for possible heart conditions such as atrial fibrillation or atrial flutter–two dysrhythmias that can cause clots to form due to inadequate bloodflow–prophylactic treatment of deep vein thromboses–which are blood clots formed in deep veins, usually in the legs–smoking cessation if applicable, and cholesterol medication.
Higgins said that the award is a recognition to the entire system. He also said that it is a team effort by providers that made the award possible.
“I liken it to a NASCAR pit stop crew,” he said. “You need a whole team to come together and pull it through together.”
