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FAST Moves Save Lives

By Susan Bush
11:36AM / Friday, May 11, 2007
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David Delano [file photo]
North Adams - A response should be FAST.

For most stroke patients, administration of clot-busters known as tPAs can greatly reduce brain tissue damage generated by stroke but the window for introducing the medication is short and precise: three hours from the onset of symptoms.

Signs of stroke are being presented with the FAST acronym to enhance community awareness. Facial weakness [which may interfere with the ability to smile or result in a drooping appearance about the eyes and mouth, Arm weakness, and Speech difficulty mean that it is time for someone to Act, according to information posted at a www.strokefoundation.com Internet website.

Community Betterment

Acting fast means getting medical help immediately.

Those brought to the North Adams Regional Hospital with stroke symptoms may be assessed by a NARH emergency room medical team and a Massachusetts General Hospital neurologist courtesy of a telemedicine system that's been in place since 2005.

"We've used this over the past year about 10 times," said Northern Berkshire Healthcare Director of Information Technology David Delano. "The contract we have with Mass General is for 10 cases a year."

The costs of the service are paid by the hospital and are not offset through insurance reimbursements or other means, Delano said.

"We do this strictly for the betterment of the community," he said.

Contract costs were not disclosed.

Real-Time Video Conferences With MGH Neurologists

The tele-conferencing is governed by very strict guidelines and those guidelines underscore the importance of rapid response to stroke symptoms. Once an individual is believed to be impacted by a stroke, hospital personnel use a pager number to contact the Boston-based hospital.

"This happens as soon as we are notified that we have a likely stroke patient," Delano said.

A person suspected of having a stroke will be sent to the hospital's radiology department for CT scans, and scan images, which detect things such as bleeding in the brain, are electronically transferred to neurologists at MGH for scrutiny, Delano said.

Under the established protocol, when the patient is returned to the ER treatment room, a two-way video conference is connected and a real-time patient assessment by a MGH neurologist and NARH emergency department medical staff gets underway. Once all available information is reviewed, treatment may begin, including the use of tPA medications if required.

The process unfolds within the three-hour tPA window if a person is brought to the hospital as soon as symptoms present.

"Over time, we are trying to get community members to recognize signs of a stroke," he said. "Because of the time-line, it is imperative to seek treatment."

Stroke Affects About 700,000 People Yearly

Should a person experience mild symptoms that they do not recognize and not seek medical help until hours or a day or two later, the medication cannot be introduced, said Delano and NBH Director of
Public relations Paul Hopkins.

According to recent statistics released by the American Heart Association, about 700,000 individuals nation-wide experience a new or subsequent stroke. According to calculations, a person suffers a stroke every 45 seconds in this country, and on a yearly basis, 46,000 more women than men will experience a stroke.

During 2004, stroke was responsible for one out of every 16 deaths, according to the AHA information. Smoking and hypertension [high blood pressure] increase stroke risk, and a consistent level of moderate physical activity can reduce the risk of stroke, according to the information.

Not Window-Dressing

Stroke warning signs include sudden numbness or weakness in the arms, legs, or face, sudden confusion in speaking or understanding, sudden dizziness, difficulty walking, loss of balance, sudden severe headache or sudden loss of vision in one or both eyes. If any of these symptoms present, Delano urged people to follow the acronym and seek assistance FAST.

"Even if someone vaguely believes that it might be a stroke, they should get to the hospital," he said. "We have this wonderful service here at a community hospital and it's not just window-dressing."

May is National Stroke Awareness Month. Additional information about stroke may be acquired at a www.stroke.org Internet web site.
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