Friday, October 29, 2010

On October 29, 2010 World Stroke Day the Opportunity for Treating Stroke Widens

Extending the time for administering life-saving clot busting therapy from 3 to 4 and a half hours means that more people will be treated

TORONTO, October 29, 2010 /Canada NewsWire/ - Paramedics working in the province of Ontario will soon be able to transport more people who suffer a sudden onset of stroke symptoms to the designated stroke centre so that they can receive thrombolytic therapy, according to a new protocol to be released this fall in the Revised Paramedic Prompt Card for Acute Stroke Protocol Training Bulletin for Paramedics by the Ministry of Health and Long-Term Care Emergency Health Services Branch in collaboration with the Ontario Stroke Network.

Now, new stroke patients have up to 4.5 hours from the sudden onset of their symptoms to possibly be treated with clot busting drugs. Before the protocol was revised, they had 3 hours. However, people who suffer from a sudden onset of stroke symptoms shouldn't wait; they should call 9-1-1 immediately or their local emergency number in order to get to a stroke centre to optimize treatment benefit.

Remember Time is Brain.

"The window for treatment has expanded from 3 to 4.5 hours, so the paramedics have to get the patient there an hour before so the tests can be done to make sure the patient qualifies for treatment," said Jason Prpic, MD, Emergency Physician representative for the Ontario Stroke Network and President of Sudbury Emergency Services in Sudbury. "Currently, paramedics in Ontario bypass certain hospitals and go straight to a stroke center. This way they will not delay the treatment by going to a hospital that cannot offer thrombolysis (clot busting drug)."
However, he cautioned, "Just because you have more time doesn't mean you should take more time. You still want to get to care as fast as you can."

"The extra 90 minutes means that many more patients will be able to be treated," said Cheryl Moher, Regional Program Manager for the Central East Stroke Network in Barrie. "In the past we have had a 3 hour time window from the onset of stroke symptoms until the drug could be delivered. But you really need a very tight system for that to work," Ms Moher said. "Through research, we now know that we can extend that time safely to a 4.5 hour window. This doesn't mean that people with stroke should take more time to call 9-1-1, but it means that more people may benefit because of the extension of this window." First and foremost, everyone must know the warning signs of stroke and act immediately if they or someone else has any symptoms, said Ms Moher. "Stroke can be treated".

The new protocol is based on the findings from a large European study that included almost 24,000 patients with acute stroke. Of these patients, some 2400 were treated with the thrombolytic drug alteplase in the extended time window, three to four and a half hours after their stroke symptoms began.

The investigators believed that extending the treatment window would be safe, and they were right. The patients who were treated up to 4.5 hours after the onset of their stroke symptoms also had positive results from the treatment.

Tom Bedford, Manager of Ambulance Services and Emergency Programs Lennox-Addington County added: "Paramedic services have been closely involved in the development of the out-of-hospital portion of the Ontario stroke protocol. Stroke is now treatable due to the input and assistance of the paramedics. It's a testimony to the cooperation between the pre-hospital and the medical communities."

Today, October 29, 2010 is World Stroke Day, and the World Stroke Organization is launching a campaign titled "One in Six". The purpose of the campaign is to bring awareness that "One in Six" people world wide will have a stroke in their lifetime and that everyone is at risk for having a stroke and the situation could worsen. The "One in Six" campaign communicates that stroke is preventable and people who have a stroke can recover and regain quality of life. The "One in Six" two year campaign focuses on six challenges to reduce the risk of stroke and its effects:

...Know your risk factors (high blood pressure, diabetes, high cholesterol)

...Be physically active and exercise regularly

...Avoid obesity by eating a healthy diet

...Limit alcohol consumption

...Avoid cigarette smoke. If you smoke, seek help to learn how to quit.

...Learning and recognize the warning signs of stroke and call 911 or your local emergency number

According to information from the Heart and Stroke Foundation of Canada, the warning signs of stroke are the following:

...Weakness - Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary.

...Trouble speaking-Sudden difficulty speaking or understanding or sudden confusion, even if temporary

...Vision problems - Sudden trouble with vision, even if temporary

...Headache - Sudden severe and unusual headache

...Dizziness - Sudden loss of balance, especially with any of the above signs

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