CHARLOTTE, NC -- A comprehensive stroke network that will provide rapid, state-of-the-art treatment to patients suffering an acute stroke has been established by Carolinas HealthCare System (CHS).
Called the Carolinas Stroke Network, this system of care will raise the current standards for diagnosis and treatment among participating hospitals. Features will include offering hospitals 24/7 access to stroke treatment experts who will help determine the best treatment plan for each patient and coordinate rapid transfer to comprehensive stroke centers for patients needing more advanced, specialized care.
The network’s two comprehensive stroke centers will be Carolinas Medical Center (CMC) and CMC-NorthEast, which hold Primary Stroke Center designations from The Joint Commission and whose stroke programs have received national awards for exemplary performance from the American Stroke Association.
Initially, the network will include all CMC hospitals in Mecklenburg and Cabarrus counties (CMC, CMC-Mercy, CMC-Pineville, CMC-University and CMC-NorthEast), as well as Cleveland Regional Medical Center in Cleveland County, CMC-Union in Union County, Blue Ridge HealthCare (including Valdese and Grace Hospitals) and Scotland Health Care System in Scotland County. Eventually, all CMC hospitals in North Carolina and South Carolina will be included, as well as non-CMC hospitals that choose to take advantage of CHS’s expertise in stroke care.
Similar to the treatment of heart attack, the more quickly emergency care can be provided to some stroke patients, the better the outcome. “Treatment of acute strokes caused by blood clots in the brain is extremely time sensitive,” said Dr. Andrew Asimos, an emergency medicine physician and Director of Emergency Stroke Care at CMC. “More importantly, the decision of when and how to treat patients must be made very carefully. Through our multidisciplinary team and experience in treating stroke at CMC, our network will enhance acute stroke treatment decision-making throughout the region.”
Patients arriving at Carolinas Stroke Network hospitals will be diagnosed and treated comprehensively, giving them the best opportunity for a good outcome. Emergency department staff will contact a regional referral neurologist located at CMC or CMC-NorthEast who will help assess the patient.
Brain scanning results will be instantly shared with the neurologist through CHS’s electronic medical records system. Test results and observations will determine the appropriate course of treatment, which may include delivery of a blood clot-dissolving drug called tissue plasminogen activator, or tPA.
In some cases, patients will be transferred to CMC for more advanced catheter-based treatments. These treatments are available 24/7 and will be delivered by an emergency neuro-interventional service.
“The goal of our network is to improve the quality of acute stroke care across hospitals in the region,” said Dr. Steve Dibert, Director of Stroke and Inpatient Neurology at CMC. “This includes expanding the use of clot-dissolving medication in emergency departments throughout the Carolinas. We’ve developed guidelines to help medical personnel determine who is a good candidate for tPA,” Dr. Dibert said, “and we will be able to identify patients sooner who might require a more advanced technique to manage their stroke.”
A study by the National Institute of Neurological Disorders and Stoke published in the New England Journal of Medicine revealed that stroke patients receiving the clot-dissolving drug have 30 percent less disability after three months than those who were not given the drug.
An example of how a coordinated system of care can lead to a dramatic medical recovery is Jerry Lingerfelt, a 67-year-old Shelby resident who had a stroke on August 30, 2009.
“I first noticed something was wrong when I went to work and dropped my keys a couple of times,” Lingerfelt said. “I was standing behind a desk and the next thing I knew I went down on the floor. My son was with me and I guess if he hadn’t been there, I might not have made it. He kept asking me what was wrong. I was awake, but I didn’t know what was going on.”
When the rescue squad arrived, Lingerfelt was first taken to Cleveland Regional Medical Center where he exhibited slurred speech and weakness on his right side. His condition improved, but he was sent to CMC for further evaluation. While in the emergency department at CMC, his condition worsened. Tests revealed a significant blockage and it was decided to remove this blockage using a tiny vacuum device called the Penumbra. He was discharged from the hospital five days later.
Lingerfelt said “my family and I are tickled to death” with the outcome. “They were told that my right side might be paralyzed. When I left the hospital, I had a little bit of a problem with my right hand, but that went away.” He is driving his car again and in mid October returned to his part-time job as manager of a Veterans of Foreign Wars club.
“There is no question in my mind that if we had not been able to offer Mr. Lingerfelt the advanced techniques in clot extraction available at CMC, he would have been significantly disabled the rest of his life,” Dr. Dibert said.
“We live in an area referred to as the Stroke Belt, which has the highest rates of stroke in the nation,” Dr. Dibert added. “Cases like Mr. Lingerfelt’s put a human face on the problem and remind us of the positive impact we will have on victims of stroke throughout the region once the Carolinas Stroke Network is fully operational.”
