“Time is brain!” This is a common saying among neurologists and other healthcare professionals who deal with stroke patients. Why? Because every second counts when you’re trying to limit the damage that can result from a stroke.
A stroke is caused by a blood clot blocking an artery, known as an ischemic stroke (80% of strokes), or by a burst blood vessel, known as a hemorrhagic stroke. Either condition will prevent oxygen from getting to parts of the brain. Within four minutes without oxygen, brain cells begin to die. It is estimated that after this point, two million brain cells die every two minutes.
While the healthy adult brain contains billions of cells, the functioning of the brain is incredibly complex; a single firing neuron can transmit to thousands of others simultaneously. The loss of hundreds of millions of cells that could occur in the delayed treatment of a stroke could cause permanent damage and possibly death.
The danger of in-hospital strokes
When a person has a stroke outside of the hospital, someone else often notices fairly quickly due to slurred speech, weakness on one side of the face or arm, or disoriented thinking. This prompts a 911 call that brings EMTs who can quickly begin stroke protocol. Usually, less than an hour has gone by since the stroke occurred.
But when someone is in the hospital, these common signs of stroke are often missed because the person may be sedated or intubated, or there is little interaction with the patient. Studies show that half of all in-hospital strokes are not identified for more than four hours after onset.
Cutting stroke detection time in the hospital
An estimated 7-15% of all strokes occur in the hospital. The medical community is aware of the critical need to speed up stroke detection and is working on a variety of approaches to find the most effective protocols. Various levels of stroke centers have been developed that have the ability to detect and treat strokes quickly and can act as centers to which stroke patients can be sent from other hospitals.
One study, reported in the Journal of Hospital Medicine, followed the establishment of stroke protocols at the University of Colorado Hospital and showed some improvement in the implementation year compared to the prior year. The study did not include the emergency department.
In the prior year, administrative coding identified 13 in-hospital strokes. Only 10 stroke alerts were initiated, of which 7 were true ischemic strokes, giving a 30% false alarm rate and leaving 6 strokes undetected (46%).
In the year following program implementation, coding identified 25 in-hospital strokes. There were 44 stroke alerts, of which only 22 were true ischemic strokes, giving a 50% false alarm rate but leaving only 3 strokes undetected (12%).
Thus, stroke team activation for true ischemic strokes increased from 54% to 88%, but false alarms increased from 30% to 50%. In addition, the amount of time to detect these strokes decreased: from a median of 271 minutes (4.5 hours) to 74 minutes.
Making it a win-win for both patient and hospital
The University of Colorado Hospital study is just one example of various programs designed to decrease the time it takes to recognize, evaluate, and treat strokes. After instituting the stroke team and protocols, more strokes were identified and they were identified more quickly, although still not quite as quickly as the average out-of-hospital stroke. These improvements are great news for patients.
However, the improvement came with an increased cost for the hospital due to a significant increase in false alarms. This not only causes a drain on limited staff resources, but it could also draw medical personnel away from other patients, possibly causing adverse effects that are not recognized in the study.
Hospitals need a method that will decrease stroke detection time while avoiding false alarms. The Neuralert Stroke Detection Monitor provides both these benefits to hospitals, with faster detection and near-zero false alarms.
Neuralert has been shown in studies to detect 80% of ischemic strokes in less than one hour. Combining a unique, non-invasive wristband technology with a state-of-the-art patented algorithm developed by the University of Pennsylvania, Neuralert detects asymmetry in arm movement, one of the initial indications of stroke onset. Because Neuralert’s algorithm is able to rule out other reasons for asymmetry (for instance, an IV in the arm, eating, or talking on the phone) the frequency of false alerts is extremely low.
Your hospital staff will know that when they get an alert from Neuralert technology, the patient needs immediate attention. Partner with Neuralert to provide your patients with the very highest standard of care, cut response times to in-hospital strokes significantly, and improve outcomes without wasting the valuable time of your medical staff.