Deans' stroke musings: Stroke Transport: Faster! Faster! Faster!

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.

Monday, August 26, 2019

Stroke Transport: Faster! Faster! Faster!

Useless, Useless, Useless! Until we know how fast is fast enough to get to 100% recovery this is all useless crapola. No exact goal, NO PROGRESS.

Stroke Transport: Faster! Faster! Faster!

Mobile stroke units quicken surgical treatment by 10 minutes

by Christopher Cheney, HealthLeaders Media August 25, 2019

For stroke patients who undergo intra-arterial thrombectomy (IAT), mobile stroke units generated faster surgical treatment times compared to ordinary emergency medical service transport, recent research shows.
"Time is brain" has been a maxim in stroke care for more than a decade. Research published earlier this year indicates brain cell loss during acute ischemic stroke (AIS) ranges from 35,000 cells per minute to more than 27 million cells per minute in "fast progressor" patients.
Intravenous administration of tissue-type plasminogen activator (tPA) and IAT are two of the primary standard-of-care interventions for stroke. IAT is performed mainly at tertiary care hospitals.
In the study published in Stroke, mobile stroke units (MSUs) were associated with a 10-minute gain in a key IAT workflow metric: emergency room arrival to treatment time, or door-to-puncture-time (DTPT). The median DTPT time for MSU patients was 89 minutes compared to 99 minutes for emergency medical services patients.
Several factors contributed to DTPT time rates, including getting patients to the right hospital at the right time, identification of a large vessel occlusion by imaging, and alerting the appropriate teams involved in patient care, lead author Alexandra Czap, MD, said.
"Mobile stroke units can make many of these factors happen more quickly, due to the availability of experts on the mobile stroke unit, the ability to do imaging in the field, and direct communication between the mobile stroke unit and hospital teams," said Czap, a vascular neurology fellow at UTHealth's McGovern Medical School in Houston.
The 10-minute gain in DTPT time for patients undergoing IAT is significant, she said. "As neurologists, we know that time is brain. Studies show patients can lose up to 27 million brain cells per minute, so we know that every second counts toward helping them preserve brain function."
MSU care teams can complete several preliminary steps necessary to perform IAT such as computed tomography of the brain, neurologist assessment, tPA eligibility screening, tPA treatment when appropriate, and baseline lab testing. "Several prehospital steps performed in an MSU, including acquisition of clinical history, examination, imaging, and evaluation and administration of tPA are potentially timesaving in IAT triage pathways," Czap and her coauthors wrote in Stroke.
This report is brought to you by HealthLeaders Media.