Every minute counts during a stroke, but researchers report that potentially disabling or deadly delays occur frequently after the patient reaches the hospital’s emergency room for treatment.
Patients who have an acute ischemic stroke should be treated within 60 minutes after entering the emergency room, according to the American Heart Association/American Stroke Association. Ischemic stroke is caused by blockage within a blood vessel to the brain and is the most common type of stroke.
About half the 55,296 patients in the study, published online in February 2017 in the journal Stroke, waited longer than 60 minutes for treatment in the emergency department after being admitted.
Treatment consisted of giving stroke patients a medication called tissue plasminogen activator (Alteplase IV r-tPA) through an intravenous line in the arm. It is the only Food and Drug Administration-approved treatment for ischemic strokes.
When promptly administered the drug can save lives and reduce the long-term effects of stroke, according to the American Stroke Association. It works by dissolving the clot and improving blood flow to the brain.
Compared with stroke patients who were treated promptly with the intravenous drug, patients whose treatment was delayed were more likely to die in the hospital, have a brain hemorrhage, or not be able to walk out of the hospital without help.
Reasons for delays in acute treatment were documented in about one-third of the patients. The most frequently reported factors included:
• Medical team delays in diagnosing a stroke
• Emergency treatment of a serious co-existing condition, such as high blood pressure, seizure, or low blood sugar
• In-hospital delays
Delays in diagnosing a stroke stalled patients’ treatment by an average time of 36 minutes, while acute medical conditions delayed treatment by an average of 34 minutes.
The bottom line
The findings underscore the need to recognize stroke symptoms early and get immediate treatment. Suspect a stroke and call 911 at once if your relative suddenly experiences any of these symptoms:
• Arm weakness
• Difficulty speaking
• Facial drooping
• Weakness on one side of the body
• Loss of sight in either or both eyes
• Severe headache with no known cause
• Trouble walking
• Loss of balance
If you’re not sure whether your loved one is having a stroke, call 911 anyway.
Pete Kelly is a freelance writer based in northern New Jersey. He has been a medical editor and writer for more than two decades, focusing on diabetes, medical education, and psychiatry. He also has worked as a daily newspaper reporter and editor. He is involved in civic causes and enjoys reading and running.