When 'time is brain'

By KARIN LILLIS

Feeling Fit Editor

You're tired, and the left side of your face feels numb. Someone asks you if you're feeling all right -- they notice you're slurring your speech.

"Nah, I'm fine. Maybe I should just take a nap," you say, shrugging off loved ones who urge you to go to the emergency room. After all, you're not feeling any pain, and the weird sensations should wear off soon, right?

But your family still urges you to get emergency care -- someone is about to dial an ambulance.

Is that the right decision?

Absolutely, said Michelle Jewell, RN, progressive care unit coordinator at Fawcett Memorial Hospital, Port Charlotte.

"Strokes aren't usually painful," she said. "You might just feel a little off, so you lie down for a while. When you wake up, you're having a full-blown stroke."

And it's usually family members who recognize something is wrong.

There are two kinds of stroke -- ischemic and hemmorhagic. The first happens when a blood clot blocks a blood vessel in the brain.

The second occurs when blood vessels inside the brain burst. In both kinds, brain cells in the affected area immediately die off.

When someone has a stroke, the risk of permanent damage increases with every second the person goes without treatment.

A stroke might be a transient ischemic attack (TIA), sometimes called a "mini-stroke." Or it could be a full-blown attack that leaves brain damage -- whether minor or severe.

There is a saying among healthcare providers who look after stroke patients -- "time is brain."

Certified Primary Stroke Centers like Fawcett Memorial Hospital in Port Charlotte have specialized teams that rush to the aid of stroke patients the moment they come through the ER doors.

When a patient arrives by ambulance, EMS crews launch a stroke alert. They notify the local ER that they're transporting a patient who is showing signs of a stroke.

Immediately, a stroke team assembles to wait for the patient -- like specially trained registered nurses, emergency physicians and neurologists.

At Fawcett, the ER team coordinates care with nurses and doctors on the hospital's progressive care unit, Jewell said. Another specialized critical care team responds to stroke alerts among patients who are already in the hospital.

Like other Primary Stroke Centers, Fawcett must follow national, evidence-based standards of care. Hospitals also have to pass an onsite inspection before the Joint Commission awards stroke center certification.

Fawcett earned its first certification in 2005; the hospital undergoes Joint Commission inspections every two years to maintain the designation.

The patients, Jewell said, make all of the hard work worthwhile.

"We had a man in his mid-40s who wasn't feeling well. He was having TIAs, so (emergency room) staff treated him and sent him home," she recalled. "He came back in several days later with a full-on stroke."

Because he arrived quickly -- within a three-hour window -- the stroke team was able to administer tissue plasminogen activator medication (tPA). Also known as the clot-busting drug, tPA can stop a stroke in its tracks by restoring blood flow to the brain.

"It was amazing," Jewell said, noting the man came back to visit hospital staff a few days later. "You might have someone who left on a stretcher come walking down the hall to see you. Just one 'thank you' makes the job worthwhile."

For more information on Fawcett Memorial Hospital's Stroke Center, visit http://fawcetthospital.com/our-services/stroke/ or call 941-629-1181.

To learn more about the Joint Commission's Primary Stroke Center certification, visit www.jointcommission.org/facts_about_primary_stroke_center_certification/.