TUESDAY, April 30 (HealthDay News) -- More than one-third of
people having a stroke don't call 911, even though that's the
fastest route to potentially lifesaving treatment, a new study
"Prompt diagnosis and early management is essential to decrease morbidity and mortality after stroke," said lead researcher Dr. James Ekundayo, an assistant professor of family and community medicine at Meharry Medical College in Nashville, Tenn.
"If about one-third does not arrive by ambulance, the implication is that they will have delayed evaluation and treatment with lifesaving drugs," Ekundayo said.
For patients with ischemic stroke -- a blood clot blocking a
blood vessel in the brain -- prior research has shown that
administration of clot-busting drugs within two hours of symptom
onset greatly reduces the odds of disability three months later.
Ischemic stroke is more common than hemorrhagic stroke, which
occurs when a blood vessel bleeds into the brain.
The study -- published April 29 in the journal
Circulation: Cardiovascular Quality and Outcomes-- looked at
how more than 200,000 stroke patients arrived at hospital emergency
rooms from 2003 to 2010. About 64 percent arrived by ambulance and
the rest used other forms of transportation, the researchers
Patients who used emergency medical services (EMS) had shorter
pre-hospital and in-hospital delays, the study found. "They arrived
early, had prompter evaluation and received more rapid treatment,"
Time to treatment is faster partly because EMS notifies the
receiving hospital about the patient, "and the emergency room staff
is ready to act as soon as the patient arrives," Ekundayo added.
EMS teams also know which hospitals have advanced stroke care and
can take patients directly there.
Calls to EMS were less frequent among minority groups and in
rural areas, the researchers found.
Dr. Ralph Sacco, past president of the American Heart
Association, said this finding shows a need for "more focused
education campaigns on the importance of calling 911 among these
Sacco, chairman of neurology at the University of Miami Miller
School of Medicine, said this study "amplifies the need to call 911
if you think you are having a stroke."
Experts say "time is brain," meaning the faster a stroke patient
gets to the hospital, the better the outcome. Among patients who
arrived within two hours of symptoms starting, 79 percent had come
About 61 percent who called 911 got to the hospital within three
hours, as opposed to 40 percent who didn't call EMS, the study
About 55 percent of the ambulance callers had a brain scan
within 25 minutes of arrival at the emergency room, compared with
36 percent who didn't use EMS. Those eligible for a clot-busting
drug received it sooner if they used an ambulance: 67 percent using
EMS got the drug within three hours of symptoms starting compared
to 44 percent who didn't call EMS.
Those who didn't call 911 were likely to say they didn't want to
be a bother, or they didn't recognize the severity of the symptoms,
the study authors said.
Each year in the United States nearly 800,000 people have a new
or recurrent stroke. Recognizing stroke symptoms and calling EMS
are the best way to improve the outcome, the experts said.
Experts recommend using the acronym F.A.S.T. as a simple way to
remember the symptoms of a stroke. Here are the signs:
For more information on stroke, visit the
National Stroke Association.
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