But they don't bother telling you that a few percent of those eligible for tPA actually get it or that tPA only fully works to reverse the stroke 12% of the time. Complete lying by omission. Until we get our stroke medical professionals off this mindset that F.A.S.T. is working will we finally get to solutions that will help a hell of a lot more survivors. Does no one think in stroke at all? But then this is from the American Stroke Association so I shouldn't expect anything useful from them.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=153501&CultureCode=en
Intense education can help stroke survivors quickly recognize
symptoms of a subsequent stroke and seek prompt treatment, according to a
study in Stroke, Journal of the American Heart Association.
Few stroke patients arrive at an emergency department within three
hours of symptom onset. The U.S. FDA has approved the clot-busting drug
tissue plasminogen activator, or tPA, to be given within three hours of
symptom onset, while the American Heart Association/American Stroke
Association suggest it can be given up to 4.5 hours in some patients.
A study called Stroke Warning Information and Faster Treatment
(SWIFT) compared interactive intervention with enhanced educational
materials on recurrent stroke arrival times in patients with mild stroke
or transient ischemic attack (TIA).
Both intervention groups received standardized packets of material
focused on being prepared to recognize and react to stroke symptoms plus
a medical alert bracelet so medical professionals would recognize them
as SWIFT participants. The interactive intervention group also received
in-hospital group sessions featuring role-playing techniques to describe
stroke symptoms to EMS workers and video presentations from stroke
survivors on preparedness.
The single-center randomized trial included 1,193 mild stroke or TIA
survivors, average age 63. Half were women, 51 percent were Hispanic, 26
percent were white and 17 percent were black. During the five-year
study, 224 patients experienced a recurrent stroke or stroke-like
symptoms. Researchers found that an unprecedented 42 percent of these
patients arrived to the emergency room within 3 hours compared to only
28 percent at baseline, a 49 percent increase in the proportion of all
patients arriving within three hours of symptom onset. Among Hispanics,
there was a 63 percent increase.
This may be the first stroke intervention to reduce racial and ethnic disparities in hospital arrival times.
“Racial-ethnic minorities suffer more strokes and worse stroke
outcomes than white Americans and they often show up later to an
emergency room to seek critical treatments,” said Bernadette
Boden-Albala, M.P.H., Dr.P.H., lead author and professor of public
health, Dentistry and Neurology and Associate Dean of Program
Development, at Global Institute of Public Health at New York University
in New York.
“Our study is the first to show that culturally tailored, health
literature educational materials can decrease these racial disparities
in stroke preparedness outcomes.”
Both the intensive intervention and the culturally tailored
educational messages were likely to decrease time to emergency room
arrival, however the intensive intervention appeared to be more
beneficial in those with early recurrent events within the first 30
days, researchrers said.
“The continued low rates of people arriving to the emergency
department within three hours of stroke symptoms suggests that we may
not be effectively disseminating existing materials on stroke
preparedness,” Boden-Albala said. “Our findings suggest that at minimum
clear, simple, preparedness-focused messages before hospital discharge –
and possibly follow-up reinforcement – results in greater proportion of
early emergency room arrivals.”
Co-authors are Joshua Stillman, M.D.; Eric T. Roberts, M.P.H.; Leigh
Quarles, M.P.H.; M. Maria Glymour, Sc.D.; Ji Chong, M.D.; Harmon Moats,
M.P.H.; Veronica Torrico, M.A.; and Michael C. Parides, Ph.D. Author
disclosures are on the manuscript.
The National Institue of Neurolgoical Disorders and Stroke and the Robert Wood Johnson Foundation funded the study.
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