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What to Do If Having a Stroke: Call for EMS

 

by the Go Red For Women Editors

Study shows many stroke victims do not call an ambulance

At signs of a stroke, quick treatment is critical. However, more than a third of stroke patients don’t get to the hospital by ambulance, even though that’s the fastest way to get there, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Researchers studied records on more than 204,000 stroke patients arriving at emergency rooms at 1,563 hospitals participating in the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke quality improvement program in 2003-10.

Emergency medical services (EMS) transported 63.7 percent of the patients, with the rest arriving in various other ways, researchers said.

EMS transported 79 percent of those who got to the hospital within two hours of the start of their symptoms. That resulted in earlier arrival, quicker evaluation and faster treatment. The researchers also found:

  • Almost 61 percent of people transported by EMS got to the hospital within three hours of the first symptoms, compared to 40 percent who didn’t use EMS;
  • Almost 55 percent using EMS had a brain scan within 25 minutes of hospital arrival, compared to 35.6 percent who didn’t use EMS;
  • Of patients eligible for a clot-busting drug, 67.3 percent using EMS received it within three hours of symptom onset, compared to 44.1 percent who didn’t use EMS.

There are more reasons to call for an ambulance rather than drive a stroke vicitim.

“EMS are able to give the hospital a heads up, and that grabs the attention of the emergency room staff to be ready to act as soon as the patient arrives,” says Jeffrey L. Saver, M.D., senior author of the study and director of the UCLA Comprehensive Stroke Center in Los Angeles, CA. “The ambulance crew also knows which hospitals in the area have qualified stroke centers. Patients don’t lose time going to one hospital only to be referred to another that can provide more advanced care if needed, whether that’s drugs to bust up the clot or device procedures to remove it.”

Minorities and rural residents were less likely to call for EMS at the signs of a stroke, researchers found.

“A number of factors can fuel the reluctance to call 9-1-1,” says James Ekundayo, M.D., Dr.P.H., lead author of the study and assistant professor in the Department of Family and Community Medicine at Meharry Medical College in Nashville, TN. “People may not recognize symptoms and may delay seeking medical care or call their doctor instead.

“We hear people say they just didn’t want to be a bother, but many times there could have been a better outcome if EMS had been called.”

About 795,000 Americans experience a new or recurrent stroke each year — a stroke every 40 seconds or a related death every four minutes.

How to recognize the signs of a stroke

The American Heart Association/American Stroke Association’s F.A.S.T. campaign can help you recognize a stroke:

  • Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile.
  • Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty – Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1 – If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

“Your life, your brain, depends on calling 9-1-1,” Saver says. “Know the signs and act fast if you or someone you’re with is having stroke symptoms.”

The American Stroke Association has more information about stroke. And keep an eye out for their new stroke PSA, airing now.