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Slow Response Keeps Stroke Victims from Receiving Drug Therapy

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Slow Response Keeps Stroke Victims from Therapy

Slow Response Keeps Stroke Victims from Receiving Drug Therapy

April 21, 2006

By: Jesse Ball for Veins1

A new study, published in a recent issue of Neurology, reports a startling conclusion; only 2 percent of admitted stroke victims received the clot-buster drug tPA.

Be Prepared
Stroke Symptoms to Watch For

Call an ambulance if someone is experiencing the following symptoms:

  • Sudden numbness in leg, face, or arm, especially on only one side of body.

  • Confusion, disorientation.

  • Vision trouble in one or both eyes.

  • Trouble with balance and coordination; difficulty walking.

  • Severe unwarranted headache.


  • Tissue Plasminogen Activator, or tPA, dissolves clots if given within three hours of the first stroke symptoms. The drug has been an effective weapon in battling strokes, but it is useless if it is not being administered.

    “People need to learn the warning signs of stroke and call 911 immediately if they think someone might be having a stroke,” said study author Matthew Reeves, PhD, of Michigan State University in East Lansing. “A stroke is an emergency, and we now have treatments that can help.”

    If tPA is available, the question remains as to why these people are being untreated, and what can you do to ensure treatment.

    The common belief for the last decade has been that a stroke is a serious emergency akin to a heart attack, and that it requires the gravest response. But the general public doesn’t seem to be following through. In fact, stroke is the number one cause of long-term disability.

    The drug will not be administered after the three hour window has closed. Forty-three percent of stroke patients were admitted to the hospital more than three hours after symptoms began, and another 38 percent did not have information about the onset of the stroke.
    "It's very important to be able to tell the medical staff when the symptoms started," said Reeves. "It could mean the difference between receiving and not receiving treatment."

    Take Action
    Boost Your Stroke Know-How

    Arriving in an ambulance makes you seven times more likely to receive treatment.

    Women are 60 percent less likely to receive tPA than men.

    The sooner you arrive at the hospital, the more likely you are to receive tPA treatment. During the second hour you are half as likely to be treated with tPA, and in the third hour, 33 times less likely.

    The first thing then, is to be sure to arrive at the hospital as soon as possible. The second, is to make sure to tell the hospital staff when the stroke began.

    However, there is a third crucial step: Arriving in an ambulance.

    Arrival in an ambulance made stroke patients seven times more likely to receive tPA than those who came on their own.

    “People who arrive by ambulance are seen and evaluated more quickly in the emergency department,” Reeves said. “This is probably due to a combination of reasons. EMS transport allows the emergency department to be notified that an acute stroke case will be arriving. The paramedics are also able to do some simple but important background steps in the ambulance – such as completing a rapid neurological exam, putting in an IV line and drawing blood. These steps allow the hospital to then ‘fast track’ the patient through the emergency department, thus increasing the chance of meeting the three-hour deadline for tPA treatment.”

    Another study showed the same results.

    “Time is so important. Every minute counts,” said Dr. Yousef M. Mohammad, the author of a second stroke study, presented recently at the American Stroke Association's annual meeting in Florida. “There is a significant difference in what happens when you arrive by ambulance and when you arrive some other way.”

    It can be difficult to know when you are having a stroke, but it's crucial to be vigilant.
    Mohammad says, “With stroke, you don't have pain. You have numbness and weakness. Patients may say, ‘I'll wait and see what happens.’ But by the time they wait, the opportunity [for treatment] is missed.”

    Be Sure You Receive Stroke Treatment

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