NORTH ROYALTON – The fire department’s paramedics are the second in the area to receive specialized stroke care training through University Hospitals in an attempt to further bridge the gap between EMS and hospital care to more quickly and successfully treat patients.
Fire Chief Bob Chegan and Joe Toth, who works with EMS training and community outreach for UH Parma Medical Center, and Noreen Chase, UH Parma stroke program coordinator, attended the Feb. 21 city council meeting to share how the department and the hospital are collaborating through a new advanced stroke class meant to treat stroke victims quicker to save more lives and prevent the detrimental effects of stroke.
Advances have been made to shorten the time between event and treatment in cardiac care, and now University Hospitals is working with paramedics to do the same with stroke patients.
She told the audience that “time is brain,” meaning that minutes count because once a stroke occurs, the more brain circulation is blocked, the more cells die and the more cells that die, the more the effects of the stroke will present. A stoke happens when a blood clot restricts blood flow to parts of the brain.
There is a small window of time these patients have to receive the drug called tissue plasminogen activator (tPA), which dissolves clots and restores blood flow, thereby replenishing dying tissue caused by the lack of oxygen circulation to the brain. For patients 80 years old and older, that window is three hours, and for patients under 80, it is four and a half hours.
“What paramedics can tell us before the patient gets to (the hospital), the better it prepares us,” Chase explained.
In addition to the more in-depth training, the fire department was also given three iPads that allow hospital staff to watch paramedics’ in-route examinations of the patient live, so care teams are better prepped for patients’ arrival, which cuts down on the event to treatment duration, saving more tissue. Through advancement in this area, the stroke door-to-drug timeframe has been reduced from 41 minutes to 25 minutes at UH Parma.
“Paramedics go into a house and access when the last time the patient was well, get the patient into the squad, do the MENDS exam they just learned and the doctor and ER can visualize the whole exam,” Chase said. “They can learn what medication they are on so the patient can go to the emergency room right away for a CAT scan.”
Pre-hospital care, or EMS care, has become vital to hospitals. EMS units are now mini-hospitals that bring the emergency room to residents, both Chase and Chegan explained.
“It’s very important the ER works with the EMS. Pre-hospital is getting very, very important,” Chase said. “Time is brain.”
“I was part of a group of nine of us that were hired as the first medics,” Chegan added. “There was a protocol of 50 pages and 15 medications we used on a regular basis. Now the protocol is 400 pages with 50 medications. Basically we have taken the emergency room out to you. And, EMS is 80 percent of our work. University Hospitals has bridged the gap between emergency medical services and the end result. We are now an integral part of that.”
Ward 1 Councilman John Nickell said in the past two years he has experienced people close to him endure stroke, so he was relieved to hear the fire department is even more prepared than before.
“Quick care is so important to prevent tragedy,” he said.
“Time is of the essence,” Ward 3 Councilman Dan Langshaw said. “Our guys having this training is going to save more lives.”