Stroke is a medical emergency and optimizing pre-hospital care improves patient outcomes.
By Keli Cristofaro
June 1, 2019
The acronym F.A.S.T. is a tool which makes recognizing stroke easy to remember. Face – is it drooping? Arms – can you raise both? Speech – is it slurred or jumbled? Time – call 9-1-1 right away. A stroke can be mild, moderate or severe which is why FAST evaluation and treatment are needed.
Calling 9-1-1 is the best way for a person experiencing a stroke to receive the most efficient care. 77 percent of Canadians report that calling 9-1-1 is the first thing they would do if someone is having a stroke but according to research, this is not actually the case. In Canada, only 59 percent of people with stroke arrive at the hospital by ambulance. What this means is that 4 out of 10 Canadians experiencing a stroke are not calling 9-1-1. Coming to the hospital by ambulance is the safest and most beneficial way for a person to arrive and receive stroke care in a timely manner. Stroke is a medical emergency.
There are many reasons why a person does not call 9-1-1. These include thinking they could deal with the situation on their own, not actually realizing to call 9-1-1 when someone is experiencing a stroke, not wanting to cause a scene or just deciding to drive the person themselves. In Ontario, the proportion of people who experienced a stroke that arrived to hospital by ambulance is only 69 percent. In Northwestern Ontario, only 47 percent of our population arrives at their local hospital by ambulance; much lower than the province as a whole.
Northwestern Ontario residents need to be aware of the benefits of calling 9-1-1 and the expertise that paramedics bring to stroke care, especially during the critical first hours. Paramedics are trained to recognize the signs of stroke and mobilize the patient quickly. Paramedics start the time-sensitive management of stroke care including monitoring vital signs and blood glucose. Paramedics also know which hospitals are best equipped to treat a stroke in our vast region. Paramedics explore with the person experiencing a stroke and/or family members to determine the time the person was last known well, any existing health conditions, current medications and allergies. A family member is also encouraged to accompany the stroke patient to the hospital if further information may be needed. The paramedics pre-alert the hospital that a stroke patient is on their way, which is critical in activating the processes of stroke care.
The Northwestern Ontario Regional Stroke Network (NWORSN) recognizes that supporting the education of the Emergency Medical System providers is vital to seamless stroke care. The NWORSN has provided in-person training to not only the paramedics in our region but has expanded the education to the First Responder Teams. There is a dedicated group of volunteers in Northwestern Ontario on call 24/7 known as First Response Teams. These teams can assist the suspected stroke patients with support as they prepare to hand off to the paramedics as they proceed to timely life-saving services at the hospital. The First Response Teams are a vital link between the suspected stroke patient and EMS.
2016/2017 LHIN Stroke Report Cards and Progress Reports
Canadian Stroke Best Practice Recommendations: Hyperacute 5th Edition Update June 2015
Heart and Stroke Foundation: Access to Stroke Care: The Critical First Hours, 2015 Stroke Report
June is Stroke Month. Spot a Stroke F.A.S.T. Calling 9-1-1 for a suspected stroke helps to ensure the best possible outcome.
For more information, visit our website at www.nwostroke.ca or contact Keli Cristofaro, Stroke Community Engagement Specialist, Northwestern Ontario Regional Stroke Network via email email@example.com or by telephone at (807) 684-6468.