Acute Stroke Care
At the Torrance Memorial Stroke Center, treatment begins from the moment the 911 call is placed. Our paramedics are specially trained in the assessment and early management of stroke patients. As soon as they identify an acute stroke patient, they alert the Torrance Memorial Emergency Department and begin the rapid cascade of treatment that can reduce brain damage.
The paramedics can begin treatment in the field, starting medications and IVs. They then bring stroke patients to a special "back door", where our emergency team immediately converges on the patient. Our emergency physicians are all board certified, and our Nurse Champions are specially trained in acute stroke care.
The "Golden Hour"
Once the patient enters our doors, the Torrance Memorial Emergency Department is on a time line called the "golden hour". Within ten minutes of arrival, a physician sees the patient and determines whether they are having a stroke, or a different type of medical problem. Within 25 minutes, the patient is moved to imaging and receives an emergency CT scan, a critical imaging study that allows the medical team to determine which type of stroke the patient has had, or is having.
Clot Busting Drugs
The results of the CT scan helps the stroke team determine treatment. The patient who has had the most common type of stroke, a blockage of a blood vessel in the brain, may be eligible to receive the FDA-approved, thrombolytic drug, tPA (tissue plasminogen activator), commonly referred to as the "clot buster" drug. If tPA is given within the first three hours of the onset of stroke symptoms, it can greatly reduce the effects of an acute ischemic stroke. Safely giving tPA will restore blood flow to the affected part of the brain.
The American Heart Association has endorsed this three hour time window; the longer it has been since the patient first developed signs of numbness, weakness, or paralysis the more dangerous it is to give a clot busting medication to them. The clock starts ticking when the patient first has symptoms. From that moment, the stroke team has 180 minutes to begin treatment with tPA. The Pharmacy and Laboratory Departments have an important place on the Stroke Center team, enabling the physicians to begin treatment within the three-hour window. They quickly run emergency blood work and other tests, and are on call to mix medications, so that the patient receives treatment as soon as a diagnosis is confirmed.
Not everyone with a blockage qualifies for tPA. Not all patients will need a clot buster. Patients may not qualify because of underlying medical problems or other risk factors.
The key test to see whether or not it is possible to give the clot busting drug, tPA, to an acute stroke patient is a non-contrast CT scan of the brain. At Torrance Memorial, a patient receives a CT scan within 25 minutes of arriving in the Emergency Department.
A CT scan takes x-rays of the brain, in "slices" from top to bottom. The CT scan shows whether a stroke is caused by a blockage, or by bleeding. If a patient has a blockage, the physicians can then determine whether or not the patient is eligible for clot busting medication. What is therapeutic for one patient is disastrous for another. Clot busting medication can never be given for a hemorrhagic stroke, or stroke caused by a leak or rupture of a blood vessel into the brain.
Learn More About Torrance Memorial's Radiology Department