During a Stroke, Every Minute Is Critical
January 09, 2020
October 18, 2019, was a normal day like any other for North Bend resident Fay Rene. She had taken her daily three-mile walk with her friends and had eaten lunch with her husband. “I had just finished reading a long article in the New Yorker, when all of a sudden, I fell over. My right side was paralyzed, and I couldn’t talk,” says Fay. Her husband Gerald recognized these were signs of stroke and immediately called 911.
Paramedics arrived in minutes and notified Overlake’s emergency department staff they were en route.
When Fay arrived at Overlake, the stroke team was already fully assembled and ready for her. She immediately had a CT scan of her brain, which showed her stroke was ischemic, or caused by a clot. While she was treated with a front-line blood thinner (tissue plasminogen activator, or tPA), further advanced imaging revealed Fay was a candidate for mechanical thrombectomy—an advanced procedure to physically remove the clot and restore blood flow.
Thrombectomy has completely changed stroke care and saves people from the worst fear of stroke—being permanently disabled in a nursing home. Overlake recently received advanced certification, being designated as a Joint Commission Thrombectomy-Capable Stroke Center.
“Eastside residents can feel confident they have the highest level of stroke care nearby, which is critical during a stroke,” says Abhineet Chowdhary, MD, medical director of the Overlake Neuroscience Institute. “Overlake is proud to have built a stroke program that saves lives and preserves quality of life for patients who suffer strokes because they have received this transformative intervention close to home.”
Overlake’s stroke program has received numerous awards over the years, reflecting its commitment to providing patients the latest technologies and innovative treatments. Staying true to that commitment, the hospital recently implemented use of a smartphone app called Pulsara that mobilizes the stroke care team with a single tap.
Diagnosing and treating stroke is a complex process; it requires upwards of 50 individuals across more than a dozen hospital departments—from physicians in multiple specialties to nurses and imaging staff. The app works as a communication tool for team members to coordinate care through streamlined communication.
“Pulsara has given us a platform to coordinate and act quickly, sharing imaging, discussing plans for treatment and following up on results,” explains David Likosky, MD, medical director, stroke and neurohospitalist programs.
The American Stroke Association’s guideline to administer tPA is within 60 minutes from the time a patient comes arrives at the hospital. Overlake does it in 33 minutes, a 12-minute reduction since the launch of the app.
The guideline to perform thrombectomy is less than 90 minutes from hospital arrival. Overlake’s stroke team now accomplishes this procedure within 67 minutes, a 39-minute reduction.
These numbers mean patients have improved quality of life following a stroke. “With each passing minute, 1.9 million brain cells are lost. So, being able to perform a thrombectomy 39 minutes faster means 74 million cells in a person’s brain have been saved. It means patients are walking and talking and going home the very next day and not being sent to a nursing home. Your risk of disability is lessened with every single minute you save,” says stroke program manager Jennifer Kurtz.
Fay’s exceptional outcome has everything to do with acting fast—from her husband calling 911 to the quick, efficient and expert care she received at Overlake. She went home the next day with no neurological deficits. She could walk, talk and had no physical signs of having had a massive stroke, and she continues to experience no impairments.
Fay recalls when she woke up from the procedure, “My husband, son, daughter-in-law and grandson were all in the room. I said, ‘Hi guys!’ as if nothing had happened. At that time, I didn’t realize what I had been through was so serious.”
Overlake is a Certified Joint Commission Thrombectomy-Capable Stroke Center; received the Healthgrades Stroke Care Excellence Award™ in 2016–2019 and is Top 10% in the Nation for Treatment of Stroke in 2016–2019; and was recognized by the American Heart and American Stroke Associations’ Get With The Guidelines® – Stroke Gold Plus Quality Achievement Award and listed on the Target: Stroke Honor Roll.