Check this site for those hospitals in your area deemed centers meeting the AHA standards for treatment of heart problems including failure, AFib (an arrhythmia) and resuscitation as well as stroke. ‘The American Heart Association and American Stroke Association recognize the hospitals for their success in using Get With The Guidelines to improve quality of care for heart disease and stroke patients. This list is current as of May 15, 2013. It is updated monthly’.
‘Continuous quality improvement’ so end result is measurable patient health. The AHA program sets guidelines for medical personnel, offer clinical tools provides mechanism for reporting tracking and patient management tools. Workshops and webinairs for staff and patient education materials for outreach programs are also available.
A recent long-term study out of Sweden* enlisted 366,715 women some with known/diagnosed cardiovascular disease (CVD) and some w/o. The number with known CVD was 5,680 at the start of the study. Correlation was sought between anti-oxidants in their diets and risk for stroke. Women were evaluated for 11 years.
Dochandal’s Nutshell of the Findings:
-In women w/o CVD. – were 17% less likely to have a stroke.
-In women with known CVD at start who consumed high dietary antioxidants – were 46%-57% less likely to have a stroke.
-Researchers studied ‘all’ possible antioxidants not specifics like Vitamin C or E but using values for each food in their diets.
-Outcome from this study found associations based on frequency of taking antioxidants not the amounts.
You know antioxidants are good for many of health matters-right!
* Total Antioxidant Capacity of Diet and Risk of Stroke A Population-Based Prospective Cohort of Women” Susanne Rautiainen, MSc; Susanna Larsson, PhD; Jarmo Virtamo, MD; Alicja Wolk, DrMedSci
Guidelines were made 6 yrs. ago and now there is a consensus resulting in a new document for medical personnel with ‘21 new recommendations as well as 50 revisions’ of existing recommendations*. To give you an idea of the complexity of aggressive stroke care– another 42 recommendations remain unchanged. In the past many patients having a stroke were excluded from receiving a clot-buster, now many of these contraindications have been dropped. These include those with a minor stroke, a rapidly improving stroke, recent major surgery, or a recent heart attack. It was believed but now proven incorrect that patients with minor or improving stroke should not get clot-busters
EMS also needs to be ready to bypass hospitals that may not offer certain procedures, such as advanced CT or MRI imaging (which is recommended before intravenous (IV) clot buster – tPA can be given)
As is so common in drug therapy progress – FDA has approved tPA to be given within a 3-hour window of symptom onset while in Europe, the clot-busting drug is approved for up to 4.5 hours.
Genentech, maker of tPA, asked the FDA to approve the drug for the extended 4.5-hour time frame and provided the agency with additional data. But the FDA last spring declined the request.
“For each minute the brain goes without blood flow, there are 1.9 million nerve cells that are dying, that affect 14 billion nerve connections and 7.5 miles worth of never fibers”.
Health care providers believe patients are eligible to receive tPA, within 4.5 hours of symptom onset.
“What this tells us is we should treat patients as quickly as possible to reduce the likelihood they will have disability from a stroke.”
*Jauch EC, et al “Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association” Stroke 2013; 44; DOI: 10.1161/STR.0b013e318284056a.