Delonna Hood, a 54-year-old woman in good health, was decorating a room
with friends at 10:30
p.m. on a Friday last year. They were assisting a high school buddy to
set up for her 50th birthday party, which was to take place the next evening.
She had driven to Los Angeles from Victorville to help her friends get ready.
As she was hanging ribbons, she began to “not feel well.” Tired
and thinking perhaps she was coming down with the flu, she pushed aside
her symptoms and continued to decorate. A friend noticed her fatigue and
then asked their mutual friend, a nurse practitioner, to check Delonna
out. At first, Tina Neu, RN, DNP, FNP, NE-BC, CNOR, Advanced Clinical
Educator, Division of Perioperative Services at Torrance Memorial, thought
her sluggishness signaled Delonna was just tired and under the weather.
Then something made her stop and take note.
“I made her smile, and nope. Then I made her put her hand on my arm
and it dropped. She had facial droop and slurred speech and the left side
of her body did not respond,” explains Neu. It was then she gave
her friend three baby aspirin and demanded the group send Delonna to Torrance
Memorial Medical Center immediately, as time is of the essence when treating
and recovering from
“As soon as we called, within three minutes we heard the ambulance
coming down the street, and it showed up within seven minutes. They whisked
her away. Her husband let us know she was getting treated. Within two
hours of the onset, she got the CPA (cerebral proliferative angiopathy)
treatment for acute stroke and all of her symptoms dissipated before going
to ICU,” says Neu. CPA must be given within four hours of symptom
onset, or the symptoms might remain for much longer.
Remarkably, Delonna was able to drive home to Victorville by herself Sunday
evening. She was lucky to have “gotten to the correct facility,” Neu adds.
Many stroke victims don’t fare so well due to a failure to recognize
what is happening and get diagnosed and treated quickly. Strokes are sneaky
and hard to identify as they don’t have a one-size-fits-all set
of symptoms at the same level of severity. This is why people who have
strokes often dismiss or ignore the early signs—delaying critical
treatment and making a full recovery less likely.
For instance, Neu has a relative out of state who dismissed her symptoms,
delaying treatment. The 46-year-old smoker, but nondrinker, had called
Neu just to chat. “As we spoke, I thought there was something wrong
with her speech. I told her to get checked out (at a hospital), but she
didn’t go until the next day,” says Neu. “As a result
she had mild paralysis and needed months of therapy.
“If you don’t identify symptoms and get treatment, you’ll
end up in a much worse case with lasting disability.”
TIME IS ON YOUR SIDE
Sudden loss of vision, difficulty speaking, a horrible headache—all
could be signs of a stroke (see “FAST” sidebar), and all could
inflict permanent disability. According to the American Heart Association,
each 15-minute period of time that passes between the onset of a stroke
and the time a tissue plasminogen activator—a medication that fights
and prevents clotting—is delivered to a patient, can cause irreversible damage.
With Torrance Memorial’s Telestroke program, stroke victims get diagnosed
immediately allowing for rapid treatment. This program provides round-the-clock
coverage to South Bay patients
via a partnership between Torrance Memorial Medical Center’s Lundquist
Neuroscience Institute and Cedars-Sinai Medical Center, offering 24/7
access to stroke specialists and expedited transfer of patients when higher-level
intervention is necessary. It combines video chatting technology with
the expertise of medical experts—delivering an instant and accurate
diagnosis necessary to begin critical, time-sensitive treatment.
The RP-Lite®, or Mobile Remote Presence Solution—also known as
Telestroke—is a robotic system including a camera, monitor and laptop
station. It enables one of four available Cedars-Sinai neurologists to
assist a patient remotely in the event that none of Torrance Memorial’s
neurologists are available.
Telestroke will allow Cedars-Sinai neurologists to diagnose, view brain
images and recommend action to supervising physicians as if they were
standing at the patient’s bedside, an action that will prove to
be the difference between life or death for the 450-plus stroke patients
admitted to Torrance Memorial each year.
“Strokes can occur at any time, and it is important to have access
to urgent neurologic evaluations by experts who can help decide whether
patients are eligible for Tissue Plasminogen Activator (tPA), or other
interventions as quickly as possible,” says Shlee Song, MD, medical
director of the Torrance Memorial Telestroke program, and one of its on-call
neurologists. “We’ve all seen the data, and patients have
a greater chance for better outcome and independence with early treatment,”
says Dr. Song. “Time is brain.”
RISK FACTORS FOR STROKE
- Genetic risk
- Recent antibiotic use
- Ignoring health symptoms
- Out of sync work/life balance
FAST: The Signs of Stroke
Use FAST to remember and recognize the following signs and symptoms of stroke:
F: FACE DROOPING
Ask the person to smile,
and see if one side is drooping...
A: ARM WEAKNESS
Ask the person to raise both arms...
S: SPEECH DIFFICULTY
T: TIME TO CALL 911!