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University Hospital receives Stroke Center designation from New York State; introduces stroke team for rapid treatment of stroke victims

SYRACUSE, N.Y. - In recognition of its commitment to providing the highest standards of treatment for stroke patients, University Hospital has received Stroke Center designation from the New York State Department of Health. University Hospital is the only hospital in Central New York to have received this designation.

The centerpiece of University Hospital's stroke center designation is the establishment of a stroke team, composed of physicians, pharmacists, technicians, nurses and administrators, who can be mobilized quickly to provide rapid medical diagnosis and treatment of stroke patients.

"This designation from the state health department recognizes University Hospital's thoughtful planning and commitment to providing the best, most comprehensive approach to caring for and treating stroke patients," said Phillip C. Schaengold, MBA, JD, chief executive officer of University Hospital. "The designation also underscores University Hospital's commitment to provide the best care for our patients through a collaborative approach to medicine. We have achieved this recognition because of the efforts of neurologists, emergency medicine physicians, pharmacists, nurses, technicians and hospital administrators."

To gain stroke center designation, University Hospital passed a rigorous 31-point review that examined the stroke team protocols and hospital policies for treatment of stroke, training of clinicians, neurological surgery services, patient education and immediate access to radiological services, especially CT scans.

The most critical element in caring for and treating stroke patients is time, medical experts say, and stroke centers have the ability to diagnose and treat patients quickly once they arrive through the Emergency Room door.

"Rapid treatment of stroke can save lives and prevent disability," said Tarakad Ramachandran, M.D., stroke director at University Hospital. "The ability to deliver clot-busting drugs within the first three hours of the onset of stroke symptoms can mean the difference between life and death or serious disability.

"A dedicated stroke team brings all the players to the emergency room in a matter of minutes. The CT scanner is quickly made available to provide us with the appropriate scans for diagnosis, and a pharmacists stands at the ready to mix the tissue plasminogen activitator (tPA) to dissolve the blood clot, if appropriate," he said. "Much needs to be accomplished in a short period of time, and that is why a stroke team is so important to the care and treatment of our patients."

Ramachandran said that while tPA is an appropriate response for many stroke patients, especially those suffering ischemic strokes (caused by blood clots), surgery may be the course of treatment recommended for patients with hemorrhagic stroke (caused by bleeding in the brain).

It is expected that within an hour of a suspected stroke patient's arrival to the Emergency Room, the initial physician evaluation, stroke team intervention, CT scan and interpretation, and recommended treatment can occur. "University Hospital has the environment and policies in place to facilitate this level of response and treatment," said Rochelle Clark, a registered nurse who serves as University Hospital's stroke coordinator.

Once admitted to University Hospital, stroke patients will receive care either in a neuro-intensive care unit, a neuro-stepdown unit or regular patient floor depending on the severity of the stroke. Patients also receive extensive physical therapy and rehabilitative services through University Hospital's Department of Physical Medial and Rehabilitative Medicine.

As requested by the state, University Hospital has notified area emergency medical service (EMS) providers of its designation as a stroke center. The state's Suspected Stroke Protocol requires EMS providers to transport patients to a state designated stroke center if the patient can arrive with two hours of the onset of stroke symptoms.

The EMS community plays an essential role in the stroke care, says John McCabe, M.D., chair of the Department of Emergency Medicine at University Hospital. "In many cases, EMS providers are the healthcare community's first response to the stroke victim," he said. "The stroke center designation tells EMS providers that there is an enhanced level of care available for suspected stroke patients at University Hospital."

In 2004 University Hospital treated 346 patients with stroke symptoms. With the new stroke center designation that number could rise.

Even with the advanced level of stroke care now available at University Hospital, physicians warn that ability to effectively treat stroke begins with increasing public awareness about stroke symptoms.

"It is imperative that the general public begin to treat stroke as a medical emergency just as they do a heart attack or chest pain," said Jeremy Shefner, M.D, chairman of the Department of Neurology. "At the first sign of stroke, one should call 9-1-1 immediately.

Symptoms can be reversed if the appropriate medical care is received quickly."

Shefner urged the community to be aware of stroke symptoms, which can include sudden weakness, paralysis, numbness; dimness or loss of vision; unexplained dizziness, unsteadiness or sudden falls; loss of speech, and sudden severe headache or loss of consciousness.

Key Stroke facts: o Onondaga County has the second highest stroke mortality rate in New York state (55.5 percent per 100,000 vs., the state's average of 38.4 percent)

o Stroke is the third leading cause of death and the leading cause of serious, long-term disability in the United States.

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