Commentary: What to do when having a stroke

In February, a study presented to the American Stroke Assn. in New Orleans revealed 44% of stroke victims do not go to the emergency room until after the time treatment would be safe and effective.

The study looked at 115,000 patients presenting to the emergency room from 2005-2010 with the diagnosis of stroke. Despite efforts to have patients present as soon as stroke symptoms appear, more patients than ever do not show up until too late. The study's message is clear: Call 911 immediately when having stroke symptoms.

The Laguna Beach community has access to hospitals with the ability to safely and effectively treat acute stroke. Symptoms of stroke commonly involve slurred speech, facial droop, weakness of one side of the body, difficulty finding words, loss of balance and trouble swallowing, among others. If you have any of these symptoms, call 911 immediately to have an ambulance transport you to an appropriate hospital.

Please be aware your preferred hospital may not have the appropriate facilities to treat a stroke patient, so you will be taken to the closest stroke receiving center. Nationwide, only about half of stroke patients arrive via ambulance. This proportion has not changed in the past 10 years despite the medical community's best efforts to educate the population to call an ambulance upon symptom onset. A stroke patient transported to the emergency room in the ambulance is more likely to be seen and treated quickly.

In Orange County, often paramedics will call the emergency room to alert the staff they are transporting a potential stroke victim. The patient will likely be assessed immediately by an emergency physician, who will determine whether to call a Stroke Code, which will mobilize a neurologist and interventional radiologist specially trained in the treatment of stroke.

While the treatments of stroke include medications and mechanical intervention, these therapies are only effective if you are treated within a few hours after onset of symptoms. Permanent damage to your brain occurs quickly; in fact, 2 million nerve cells die per minute during stroke. Additionally, as more damage occurs to the brain, treatment becomes more risky.

Some patients may have symptoms that begin to resolve and think they can delay their care. These patients are having a Transient Ischemic Attack, or TIA. However, patients having any of the above stroke symptoms should be evaluated immediately even if they're resolving.

The National Library of Medicine website states that more than 10% of people who have transient attacks will have a stroke within three months. Half of these strokes happen during the 48 hours after a TIA. Often a patient with transient symptoms has an underlying process such as atrial fibrillation that can be treated to help prevent a future stroke.

WILLIAM DODGE is an emergency physician at Mission Hospital Laguna Beach.

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