Good communication speeds stroke patients to crucial CT scans

Stroke victims get faster "door-to-CT" time when departments communicate effectively, especially when emergency medical staff is called while the patient is en route to the hospital.

The top three medical killers in U.S. -- heart disease, cancer, and stroke -- kill 700,000 people annually. Time is paramount in triaging acute stroke patients receiving intravenous thrombolysis, which must be performed within the "golden time," or three hours of the onset of symptoms. CT examination is a critical aspect of triage.

The study, conducted at the stroke center of the Nassau University Medical Center in East Meadow, NY, surveyed 263 patients during 2007. Most of the patients were 66 to 85 years old, and most had suffered ischemic strokes.

Brief physician assessment, utilizing the National Institutes of Health Stroke Scale, was considered instrumental to activating Nassau's multidisciplinary stroke team. Twenty-four-hour radiology coverage is available, and the CT scanner is cleared upon alert.

Some 76% of the 54 patients who arrived within three hours were evaluated within 10 minutes. In five of the 54 cases in which emergency medical staff was notified while the patient was being transported, door-to-doctor time was reduced to less than three minutes.

All patients who were given IV tissue plasminogen activator met the 25 minute door-to-CT and 45-minute door-to-interpretation recommended times.

Along with notifying emergency medical staff during patient transport, quality assurance "drill downs" were named as essential elements in expediting care for stroke patients.