Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, February 9, 2019

Target: Stroke program demonstrates substantially improved outcomes in adherence to guidelines - DTN times

We still have no clue on what the time to shoot for to get tPA to provide full recovery. But these times are still appalling, I expect needle time while in the ambulance. Why haven't you implemented these vastly faster diagnosis methods?  

Laziness? Incompetence? Or just don't care? No leadership? No strategy? Not my job?  The board of directors didn't tell them that totally solving stroke was their job, not just lazily relying on the status quo?

 

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes

Or don't you even know about these?

 

Target: Stroke program demonstrates substantially improved outcomes in adherence to guidelines - DTN times

by American Heart Association



Hospitals implementing the American Heart Association/American Stroke Association Target: Stroke Phase II strategies decreased the median door-to-needle time from 66 minutes to 51 minutes, according to a study presented today presented in Honolulu at the American Stroke Association's International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.
The study, "Achieving More Rapid Door-to-Needle Times in Acute Ischemic Stroke," found there were substantial improvements in to alteplase administration in Get with the Guidelines-Stroke hospitals after implementation of Target: Stroke Phase II and the program's national goals were achieved with clinical outcomes also being significantly improved.
Target: Stroke is a national quality improvement initiative focused on improving care and outcomes by reducing door-to-needle (DTN) times for eligible patients treated with intravenous alteplase. The primary national of Target: Stroke Phase II was for hospitals to achieve door-to-needle times within 60 minutes for 75 percent or more of acute ischemic stroke patients treated with intravenous alteplase, with a secondary goal of 45 minutes or less DTN in 50 percent or more of the same category of patients.(What is fast enough to get full recovery using tPA? THAT IS THE TIME GOAL TO SHOOT FOR.)
The researchers found when comparing all patients treated in Phase I with Phase II, the median DTN time decreased from 66 minutes to 51 minutes(still appalling) and the percentage of patients with DTN times less than or equal to 60 minutes increased from 42 percent to 67 percent.
"It is a common saying in the stroke community – 'time is brain' - but it is entirely true," said Gregg C. Fonarow M.D. Director of the Ahmanson-UCLA Cardiomyopathy Center, co-chief of UCLA's Division of Cardiology and Professor of Cardiovascular Medicine, UCLA, Los Angeles California, lead author of the study and volunteer expert for the American Heart Association. "Every minute a stroke goes untreated a typical patient loses 1.9 million neurons – so a faster response time is critical to improved patient outcomes."
Introducing Target: Stroke Phase III
Alongside the research surrounding the program's recent success in Phase II, the American Heart Association/American Stroke Association is announcing Phase III of its Target: Stroke program.
"Phase III of this American Heart Association/American Stroke Association initiative further raises the bar by setting more aggressive targets for timely treatment with IV alteplase, "said Fonarow. "But now the aim goes beyond faster door-to-needle times. Phase III introduces a second type of intervention into the mix, setting the first-ever targets for prompt treatment with endovascular therapy."
Target: Stroke Phase III aims to continue to improve on DTN times, as well as introduce goals for door-to-device times for endovascular therapy devices. The primary goals of Phase III are achieving DTN times within 60 minutes for 85 percent or more of acute ischemic stroke patients treated with IV thrombolytics – with secondary goals of getting down to 45- and 30-minute timelines as well.(That is a pathetic goal. The goal is 100% recovery. Get some leaders who will get you there.)
"We see these goals as aggressive – but also completely attainable – and more importantly we believe that it will continue to improve outcomes and save the lives of additional acute ischemic . At the end of the day – that is everyone's goal," added Fonarow.
The Target: Stroke program helps hospitals identify best practice strategies, utilize clinical decision tools, and for patient care. Research analyzing data from this program supports the conclusion that quality improvement measures from Target: Stroke result in substantial improvement in patient care and outcomes.
There are more than 1,200 Target: Stroke hospitals across the United States.

Explore further
Study shows need for thrombectomy-capable stroke centers remains high in 64 percent of communities studied
Provided by American Heart Association

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2 comments:

  1. mareeFebruary 11, 2019 at 1:11 AM

    But, a patient would have to have a brain scan, to ascertain whether it is a blockage or a bleed, since administering the clot busting drug would make a bleed many times worse, so you have to factor that into your door to needle time.

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    Replies
    1. oc1deanFebruary 11, 2019 at 2:04 AM

      So you do the 5-10 minute brain bleed one first, then the others to actually verify the stroke. Neurologists have to be removed from the equation, they misdiagnose too many young adult strokes.

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