Treatment: tPA in the emergency room
"Four or five hours later, I was completely normal."
When medics rushed 59-year-old George Greenhalgh into the Emergency Department at EvergreenHealth Medical Center, his speech was slurred, he had numbness on his right side, and he was unable to recognize his family – all classic symptoms of a stroke.
But George had a couple of things on his side – time, and the outstanding care provided by EvergreenHealth, which has been certified a Primary Stroke Center by the Joint Commission.
George's family decided to be safe and called 9-1-1. The medics suspected stroke, and called ahead to alert the stroke team at EvergreenHealth's Kirkland emergency department.
Emergency physician Dr. Jack Handley quickly called a “stroke code,” which starts a chain of actions.
Neurologist Dr. James Song and hospitalist Dr. Johnson Loh were called in to consult.
Diagnostic Imaging prepared for immediate CT scans, with a radiologist on hand to read them.
The lab prepared to rush blood tests.
Additional nursing resources converged on the emergency room.
“Everyone makes this the number one priority,” Dr. Handley explains, “so that decisions can be made quickly, without wasting a minute, because there is only a three-hour window to treat somebody with clot-busting medications.”
In George Greenhalgh’s case, the medication was a drug called tPA – tissue plasminogen activator – which Dr. Handley calls a leading-edge treatment for people who have acute stroke.
“It dissolves blood clots that block blood flow to the brain, and can actually reverse the symptoms,” he explains. “Fortunately, George was well within the critical three-hour window to receive tPA.”
The drug worked wonders for George Greenhalgh “Four or five hours later,” he recalls, “I was completely normal!”
Primary Stroke Center
EvergreenHealth is among the only 10 percent of the nation’s hospitals are certified as Primary Stroke Centers, meaning they meet rigorous national standards for stroke care, from rapid diagnosis and treatment through rehabilitation and patient education.
“Certification is a big deal not only for EvergreenHealth, but also for the community,” explains Dr. David Likosky, a neurologist and the director of EvergreenHealth’s Stroke Program.
In addition to the advanced treatments offered, EvergreenHealth also provides a full range of inpatient and outpatient rehabilitation therapy along with education for both patients and family members to help them avoid future strokes.
A program coordinator oversees the program and tracks patient outcomes.
With clot-busting medications such as tPA becoming an emergency department standard, and with every second critical to a successful recovery, Dr. Likosky stresses, “If you feel there’s even a possibility that you’re having a stroke, I can’t emphasize enough that you need to seek help right away.”
That was certainly the case for George Greenhalgh.
“It's an amazing thing to see.”
Because EvergreenHealth has the systems in place to immediately diagnose and treat stroke, it turned what could have been a disaster into a pretty remarkable story.
“Without the rapid treatment, George Greenhalgh would have been going to a nursing home,” Dr. Likosky explains. “Instead, he was able to walk out of the hospital with no speech difficulties, no numbness, and no need for rehabilitation. It’s an amazing thing to see.”
George Greenhalgh knows he was lucky – that his family called 9-1-1 quickly, and that he was taken to a hospital with an advanced stroke program in place. “I was very, very fortunate,” he smiles.
For More Information on stroke care at EvergreenHealth