News Release
Use of medication in treatment of stroke introduced in Niagara: Timing is crucial
- Date of Issue: Monday, July 11, 2005
- Français
NIAGARA , ON - As of today, physicians and nurses specially trained in stroke care at the Greater Niagara General Site of the Niagara Health System (NHS) will begin administering a clot-dissolving drug to patients which may improve the outcome of ischemic stroke.
The use of the thrombolytic drug t-PA (tissue plasminogen activator) is one of the most important recent advancements in the treatment of ischemic stroke (a stroke caused by a blood clot). It must be administered to an ischemic stroke patient within three hours of the onset of symptoms. According to the Heart and Stroke Foundation, some patients who receive t-PA have a complete reversal of their symptoms such as weakness on one side or the inability to speak.
"Stroke is a leading cause of death and disability in Ontario, and the Niagara Health System has worked very hard to enhance specialty care for our stroke patients," says Leanne Hammond, District Stroke Care Coordinator with the NHS. "This new initiative will ensure that ischemic stroke patients have access to the latest treatment available. However, it is also important to note that increasing awareness of the risk factors and warning signs of stroke will play a vital role in reducing the number of strokes and Transient Ischemic Attacks (TIAs) in Niagara. The most effective treatment is still prevention."
To be treated with t-PA (tissue Plasminogen activator), patients must arrive at the GNG Site's Emergency Department within two hours of the onset of symptoms of ischemic stroke. As first responders in the majority of ischemic stroke situations, paramedics with Niagara Emergency Medical Services (NEMS) have received specialized training to identify potential patients for the clot dissolving drug. They would transport these patients directly to the GNG hospital site for specialty care where they will be assessed by a medical team specializing in the treatment of acute stroke patients with thrombolytics. A CT scan, blood tests and other tests must be conducted prior to administering t-PA.
As part of the Niagara District Stroke Program, this new program will be available 24 hours a day, seven days a week. The initiative is also part of the Ontario Stroke Strategy, supported by the Ministry of Health and Long-Term Care (MOHLTC). The $30-million provincial stroke strategy is being implemented in phases across the province as part of a comprehensive plan to provide education and training for health-care workers, prevention and research.
In Niagara, the GNG Site is designated as both a District Stroke Centre and a Stroke Prevention Clinic. The clinic has evolved considerably and continues to expand stroke-related services to the residents of Niagara. The clinic offers the services of a neurologist, nurse practitioner, dietitian and social worker. Services are available to all Niagara residents who have experienced a TIA, also referred to as a mini stroke, and are referred by a physician. Services include consultation, priority access to diagnostic tests, referrals to surgical services when appropriate, identification of risk factors for stroke, and risk factor modification education.
An expansion of staff means the clinic is now open for four full days per week, up from only three mornings a week last year. Since the clinic opened three years ago, the number of patient visits has steadily increased from 275 new patient visits in 2002-2003 to 475 in 2004-2005.
In addition to increasing stroke prevention services, the District Stroke Program has supported two successful pilot projects in Niagara's hospitals to enhance the care provided to stroke inpatients. The Rehabilitation Pilot Project has trialed the use of an assessment tool to ensure all stroke patients regardless of point of system entry (hospital site) are placed in the correct rehabilitation setting in a timely manner. The Dysphagia Pilot Project has developed and tested a model for management of dysphagia (difficulty swallowing – present in half of stroke patients) across the Niagara Region. The pilot project has created an educational training program for hospital staff and developed dedicated swallowing teams on patient units who are experts in delivering care to dysphagia patients.
BACKGROUNDER ON STROKE
Stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain, as a result of either a blood clot (ischemic stroke) or the rupture of a blood vessel and bleeding into or around the brain (hemorrhagic stroke).
The symptoms of stroke appear suddenly, over a few minutes or hours or at most a couple of days. Individuals should be able to recognize the five main symptoms of stroke and seek immediate medical attention if any of these symptoms occur:
- Sudden paralysis or numbness of the face, arm or leg, usually on only one side of the body;
- Sudden loss of speech or trouble understanding speech;
- Sudden loss of vision (often in one eye) or double vision;
- Sudden dizziness or loss of balance or coordination;
- Sudden severe and unusual headache (often described as "the worst headache of my life" that starts suddenly) with no known cause.
Source: Ministry of Health and Long-Term Care