The ability to rapidly recognize, diagnose, and treat strokes is a major concern of the medical community. Many efforts are being made to improve response time, diagnosis, and treatment, but these vary widely depending on the type of hospital and where you have had the stroke.
The type of hospital matters
If you are brought into the hospital because of signs of a stroke, the treatment you receive may depend on the type of hospital you are brought to. Primary stroke centers (PSC) are certified hospitals that have an acute stroke team and a neurologist available 24/7, have designated stroke beds, and have the ability to provide IV thrombolytic care.
Unfortunately, more than half of Americans live more than 60 miles from a PSC. In order to improve outcomes for stroke patients, many hospitals have the Acute Stroke-Ready Hospital (ASRH) certification. These hospitals are able to make rapid assessments, offer CT scans, and begin IV thrombolytic therapy for transfer to a more advanced center.
Some smaller or more rural hospitals do not have the staffing or expertise to reach the ASRH status. These hospitals may be able to diagnose a stroke but would have to rapidly transfer a patient to another hospital for better care.
The place where you have your stroke matters
Most strokes occur outside of the hospital setting and patients are brought to the emergency room for evaluation and treatment. But an estimated 17% of strokes occur when the patient is already in the hospital for another reason. Surprisingly, people who have a stroke outside of the hospital often receive evaluation and treatment much faster than hospitalized patients.
When a person is out in the world, it is likely that someone else notices signs of stroke at the onset of the stroke and calls 911. However, people who are already hospitalized are often not interacting with people on a regular basis; they may be sedated or intubated; or their symptoms may be mistaken for another condition, perhaps the condition the patient has been hospitalized for.
One common cause of in-hospital stroke is surgery. The risk of stroke during or after an operation on a tumor of the head or neck can be up to 5% and as much as 10% for heart surgery. Existing stroke risk factors, such as obesity, high blood pressure, smoking, and diabetes, increase this risk.
It is estimated that in-hospital strokes can take up to 4 hours to be identified, which can result in significant brain damage.
How strokes are assessed in the hospital
Every hospital, regardless of certification level, will have stroke protocols in place that will involve assessment and possibly activation of some level of a stroke response team, which will evaluate the stroke and determine the best treatment.
There are a variety of assessments used for evaluating a patient for a possible stroke. One of the most common is the National Institutes of Health Stroke Scale (NIHSS), which uses an 11-factor scale to measure neurological impairment. This assessment is considered the “gold standard” in clinical trials and is a quality metric for certification.
These 11 evaluations include:
- Level of consciousness, orientation questions, and response to commands
- Visual fields
- Facial movement
- Motor function of the legs
- Limb ataxia
- Sensory perception
- Extinction or inattention
With a zero in any category indicating normal, the scoring range is 0-42. The higher the score, the more serious the stroke.
Improving stroke response and treatment
Since every minute counts when evaluating and treating a stroke, hospitals and medical organizations are working steadily to research and develop the very best protocols to speed up diagnosis and develop the best treatments and technologies to limit long-term harm from a stroke.
Neuralert Technologies is one of those organizations. We are committed to ending the devastation caused by in-hospital strokes with our innovative Stroke Detection Monitor, combining a unique, non-invasive wristband technology with a state-of-the-art patented algorithm to detect 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, the frequency of false alerts is extremely low. Your hospital staff will know that when they get an alert from the Neuralert technology, the patient needs immediate attention. Neuralert has been shown in studies to detect 80% of ischemic strokes in less than one hour.
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.