Time is of the essence in dealing with stroke

A new study in Canada compared the time delay between stroke onset and stroke treatment in the emergency department (ED) and found that patients who acted immediately and arrived at the hospital early after their symptoms began actually waited longer in the ED before getting appropriate treatment than those who waited the longest before going to the ED.

This unfortunate delay is likely due to the window of opportunity that doctors have in administering IV tissue plasminogen activator (tPA), a clot-busting agent that when given within a 3 to 4.5 hour period after symptoms begin, can reverse the damage caused by the blood clot.

What likely happens is that doctors feel they have plenty of time to administer the medication if the person arrives within the first three hours of symptoms and so are likely to delay treatment whereas that time frame narrows considerably in the person who waits hours at home before seeking medical care.

However studies have shown that the sooner treatment begins during the 3 to 4.5 hour time frame, the better the outcomes.

What is disturbing about these results is that these delays took place in 13 different stroke centers, that is, centers that specialize in stroke care. Human nature being what it is, the sense of urgency diminishes when we feel we have more time to deal with the problem.

The important lesson for family members to know is that just because your loved one is now in the ED, do not assume that everything is being done in a timely fashion. Continue to advocate for timely treatment.

This result of this study was presented as an abstract at the American Academy of Neurology 61^st Annual Meeting, April 2009.