Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Sunday, July 23, 2017

GPH awarded for stroke care, education efforts - North Platte, NE

So fucking what!. 'Care' NOT results. Damn it all, do something for survivors, like get them to 100% recovery. You lazy blithering idiots, thinking 'care' is what survivors want. 
Call the president and ask for results

1. Nothing on 100% recovery statistics.
2. Nothing on 30-day deaths compared to other hospitals.
3. Nothing on the efficacy of their stroke rehab protocols.
4.  Nothing on tPA full efficacy.
5. Nothing on their misdiagnosis percentage of strokes, especially young strokes.
Guidelines prove nothing.
You'll' want to know results so
 

Call that chief executive officer(Mel McNea)
general number  (308) 568-8000  and demand to know what the RESULTS are; tPA efficacy, 30 day deaths, 100% recovery, misdiagnosis percentage.
The wothless puffery article here:
 http://www.nptelegraph.com/news/local_news/gph-awarded-for-stroke-care-education-efforts/article_a8089866-6f61-11e7-83b7-27901b8b9162.html
Every 40 seconds, someone in the U.S. has a stroke, and every four minutes, someone dies of stroke, according to the American Heart Association/American Stroke Association.
Stroke is the fifth leading cause of death in the U.S., accounting for about one in 20 deaths. It is also a leading cause of serious long-term disability.
For stroke patients, getting the proper care quickly is vital to survival. Great Plains Health was recently recognized for its efforts in treating stroke patients. GPH is one of two hospitals in Nebraska that earned the American Heart Association/American Stroke Association’s Get With The Guidelines Stroke Gold Plus achievement award. The North Platte hospital also received the AHA/ASA’s Target: Stroke Elite Plus Honor Roll Award.
At 3 p.m. on Tuesday, a representative from the associations will be at the Great Plains Health Education Center to present staff members with the award. The hospital will also be recognizing local first responders for their work to ensure that stroke patients get the care that they need.
“It’s a collective effort,” said Dr. Anil Kumar, a neurologist at Great Plains Health. “Different teams are working to save the brain.”
Most of the time, stroke patients are taken to the emergency room by crews from North Platte Fire and Rescue or fire departments from smaller communities who have requested a tiered response from North Platte, according to Fire Chief Dennis Thompson.
A stroke patient’s care usually starts with a 911 call. Thompson emphasized that people should be familiar with stroke symptoms and should call 911 immediately if someone appears to be having a stroke.
“Do not wait to see if signs and symptoms pass,” Thompson said. “Time is critical. The longer a stroke goes untreated, the greater the risk of debilitating damage to the brain.”
Other conditions have symptoms similar to a stroke, said Robin Dimmit, an emergency room technician at Great Plains Health and a paramedic with the Stapleton Volunteer Fire Department.
“Sometimes it’s a diabetic emergency,” Dimmit said, adding that alcohol-related problems also can cause strokelike symptoms.
Regardless, she said, it’s always better to be safe than sorry.
Once an ambulance arrives, the patient is loaded up and given oxygen. An IV is started and vitals are monitored as the patient is rushed to the emergency department. Paramedics assess the patient so that their findings can be used by ER staff to determine how the patient’s condition is progressing.
The crew also calls a stroke code into the ER, which activates a team of staff members including a pharmacist, laboratory technician and radiologist who wait to meet the ambulance.
“When we arrive in the Emergency Department with a stroke patient, we stop only long enough to weigh the patient while they are on our cot and then take them directly to the Radiology Department for a CT (scan),” Thompson said.
While the patient is having the CT, the cot is taken back to the scale so it can be weighed separately. This allows ER staff to determine the patient’s weight and a pharmacist to figure the dose of a drug called tissue plasminogen activator, or tPA.
“It’s a clot buster,” said Tonya Hinrichs, a pharmacist at Great Plains Health. “It will actually break up the clot in the brain that is causing the stroke.”
While tPA can be very effective, it can’t be used on many patients. Hinrichs explained that some patients may take medications that could cause an adverse reaction to tPA and could even result in death.
The time frame to use tPA is also limited, which is one of the reasons it’s so important to go to the hospital as soon as possible. Unfortunately, many people opt to wait to get treatment, said Chastity Orr, stroke program coordinator at Great Plains Health.
Farmers and ranchers can be particularly bad about trying to “rub dirt on it,” Orr said. They often think they’ll feel better if they lie down for a while, but doing so allows more irreparable damage to the brain to occur.
“In 1 to 2 seconds, a person can lose 32,000 brain cells depending on the location of their stroke,” Orr said. “That’s their mobility, their ability to talk, to eat, to recognize a family member, their behavior — everything that makes them able to function in their daily lives.”
Hinrichs said that when patients are brought in for a stroke, it’s important for someone to come with them or to be available to provide important information to the medical team, including the patient’s “last known normal.” It’s important for the staff to know when the patient was last seen acting normally so they can determine whether tPA can be administered.
“We’ve had patients come in alone,” Hinrichs said, explaining that this can be problematic because stroke patients sometimes cannot communicate.
This is because some strokes occur in the part of the brain that controls language, Kumar said. Sometimes patients suddenly can’t understand what people are saying to them; other times they can decode what they are hearing but can’t speak coherently.
Depending on the severity and location of the stroke, various forms of rehabilitation may take place to help patients get back to normal. Some experience a full recovery, while others are left permanently disabled.
Several risk factors can increase someone’s chance of having a stroke, including high blood pressure, high cholesterol, being overweight, diabetes and family history.
Training to maintain an active lifestyle, balance diet and taking precautions such as getting a stent placed if a patient is at risk for a stroke could save a person’s life later, Kumar said.
Stroke care “isn’t just treatment, it’s prevention,” Kumar said.

 

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