Fast, effective care in the Emergency Department
Though some stroke patients are transferred to Intermountain Medical Center from other facilities, the majority arrive through our Emergency Department (ED). Speed is of the essence in treating these stroke patients.
The speed with which a CT scan is done and the length of time before tPa is administered to eligible patients are key milestones. The nationwide goal is to get stroke patients to CT within 25 minutes of arrival at the ED.
In 2011, 41.4 percent of stroke patients treated here at Intermountain Medical Center were scanned within 25 minutes. The Utah average was 33.6 percent, and the national average among designated stroke centers was 25.3 percent.
Another key target in ischemic stroke treatment is to administer the clot-busting drug known as tPA within 60 minutes of arrival at the ED. We met that timeframe with 77.2 percent of our patients in 2011. That compares to the statewide average of 49.2 percent and national stroke center average of 34.6 percent.
We have made a concerted effort to coordinate fast, effective care for stroke patients:
- By the end of 2012, all physicians and nurses in the ED will have received special training on the National Institutes of Health Stroke Scale, which will make for consistent diagnosis of patients and help relay meaningful information to the stroke team.
- We have developed an Acute Stroke Emergency Response Team (ASERT), who is paged and responds within minutes of a stroke patient arriving. The team includes a neurologist (who is in-house, 24/7), a nurse practitioner, the nurse stroke coordinator, a phlebotomist, an EKG technician and a radiology transport technician.
- For patients who are eligible for tPA, pharmacists respond to the CT room and with a physician order can begin administering the drug right there, to save time.