St. John Valley

New stroke protocol saves lives

FORT KENT, Maine — The fifth leading cause of death, and a leading cause of disability in the United States, strokes kill nearly 130,000 people a year; that’s one in every 20 deaths. Every four minutes, someone dies from a stroke.

But advances in the management of stroke and the prevention of future events continue to emerge, and according to the most recent guidelines from the American Heart (AHA) and the American Stroke Associations (ASA), the current average annual rate of future stroke represents a historical low and is the result of important discoveries in prevention science.

A stroke is a disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. A transient ischemic attack (TIA), on the other hand, is a temporary blockage of blood flow to the brain and sometimes a precursor to a stroke. Unlike chest pain where it is important to take an aspirin right away at the first symptom, when the signs of a stroke are observed, aspirin must not be administered until a diagnosis is made. This is especially important if the cause of the stroke is due to bleeding into the brain resulting from a burst blood vessel, as the blood thinning properties of aspirin may worsen the condition.

When either a stroke or TIA occurs, part of the brain cannot get the blood and oxygen it needs, leading to brain cell death. With respect to a TIA, since it does not cause permanent damage and the symptoms disappear, it may seem like there is no cause for alarm, however, the ASA cautions patients that ignoring the temporary stroke symptoms is a big mistake because it can lead to stroke. The temporary symptoms should be considered important warning signs to an actual stroke and therefore must be taken seriously.

Current evidence-based recommendations for prevention and treatment strategies of stroke and TIA include antiplatelet drugs or blood thinners and effective strategies for treatment of hypertension, atrial fibrillation, arterial obstruction, and high cholesterol. New approaches and improvements in existing treatment are constantly emerging.

This was the topic of a recent continuing medical education program presented by Dr. Erik St. Pierre, Medical Director of the Emergency Department at Northern Maine Medical Center (NMMC). NMMC has been working with Neurologists at Maine Medical Center (MMC) and Eastern Maine Medical Center (EMMC) to implement the latest strategies from the AHA and the ASA in support of the best patient outcomes. Utilizing the same protocols as MMC and EMMC, a Stroke Team has been formed at NMMC to be prepared to act quickly when a patient presents with symptoms of stroke or TIA, either to the physician office or to the Emergency Department. The team includes members of prehospital care, physicians, physician assistants, nurse practitioners, ER nurses and Radiology Technologists.

Dr. St. Pierre said, “When someone has symptoms of a stroke or a TIA, they require immediate medical attention. Time based treatment is of ultimate importance in the successful treatment and recovery from an event.”

He also said patient symptoms can be varied, and often, the symptoms can mimic other conditions, making it difficult to diagnose.

Based on studies from the ASA which say that up to 80 percent of strokes are preventable, St. Pierre recommends that patients and family members pay attention to the signs and symptoms that could point to an impending stroke and to seek medical attention early. The AHA and ASA instruct the public to use the acronym FAST to remember when to take action: F for face drooping or numbness, A for arm weakness or numbness, S for speech difficulty, and T for time to call 911.

To learn more about stroke prevention and risk factors go to

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