CMH designated as Primary Stroke Center

Special team provides rapid, comprehensive care

Calvert Memorial Hospital has been designated a Primary Stroke Center by the Maryland Institute for Emergency Medical Services Systems (MIEMSS) recognizing that CMH meets or exceeds the requirements set by the state for effectively treating strokes.

Support for Survivors

The Calvert Memorial Hospital Stroke Support group meets the first Wednesday of each month from 5:30 - 7 p.m. in the KeepWell Center.

"The group is a great opportunity for survivors and caregivers to share and learn from one another's experiences," said Jackie Smith, an occupational therapist at CMH. She facilitates the group with speech pathologist Carrie Pereyra.

"We have about 25 who regularly attend," she said. "Some have been coming since we started (in 2004). They enjoy it that much." For information, call 410-414-4800.

"This designation assures stroke patients that CMH is using the latest and best therapies and treatments to ensure the best possible outcomes," said Dr. Harry Kerasidis, director of the program at Calvert Memorial Hospital.

In addition, the designation permits Emergency Medical Services (EMS) personnel to transport apparent stroke patients to CMH over a non-designated center.

To receive the designation as a Primary Stroke Center, Calvert's program went through a rigorous application process and submitted data on stroke admissions, treatment plans and outcomes, according to Susan Dohony, vice president for performance improvement at CMH.

The final step was an onsite inspection by the MIEMSS survey team in December. "They evaluated our processes, interviewed staff and looked at our outcomes," said Dohony.

Team optimizes care
"We know that rapid treatment for stroke can save lives and reduce disability," said Kerasidis, "that's why we have a multidisciplinary team in place that can respond quickly in these cases. Once a patient is recognized as having a potential stroke, the entire team is simultaneously activated to care for that individual."

At CMH, the stroke team includes EMS, physicians, nurses, radiology and laboratory technicians, rehabilitation specialists (physical, occupational and speech therapists), pharmacists and case managers. "This integrated and pre-coordinated approach streamlines the entire process," he said. "We've set up protocols and pathways to get these patients through the system as quickly as possible."

He went on to add, "The team follows these patients throughout their entire stay, from admission and treatment to discharge and rehabilitation."

Dohony said that staff education is important, as well. "All of the nurses and physicians in our emergency department completed seven hours of specialized stroke training," she said, "as well as the clinical staff who care for these patients after they're admitted."

"We are continually working to improve patient care and outcomes," said Dohony. Last year, CMH joined the national database 'Get with the Guidelines' sponsored by the American Heart Association. "This allows us to measure our performance against the best hospitals in the country," she said.

Early identification stressed
A stroke is a "brain attack" that cuts off vital blood flow and oxygen to the brain. It is the third leading cause of death (behind cancer and heart disease) and the leading cause of adult disability in the United States.

In 2007, 668 people ages 41-86 came to CMH with suspected stroke symptoms. Of that number, 159 were admitted and 94 were transferred for tertiary or specialized care. The others were referred for follow-up care.

One of the most recent advancements in the treatment of strokes is the "clot-busting" medication tPA (tissue plasminogen activator). However, this medication can only be administered, said Kerasidis within three hours of the onset of symptoms, and only after the patient has been medically assessed and had a CT scan of the brain.

"I cannot emphasize enough the need to come in earlier," said Dohony. "Only a handful come within the three-hour window. Most people either ignore the symptoms, wait to see if they'll go away or wake up with the effects."

Stroke symptoms include:

Sudden numbness or weakness of face, arm or leg TH especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden severe headache with no known cause.

"This is the real challenge," said Dr. Kraig Melville, chief of emergency medical services at CMH, "to get stroke victims to come to the hospital in a timely manner."

"The longer they wait," said Melville, "the more damage is done and the less options we have available to us."

According to Melville, CMH has partnered with the Washington Hospital Center to provide tertiary care for stroke patients. "This relationship is vital," he said, "because they're able to provide more therapeutic options for those patients who are not candidates for tPA."

Every minute counts when it comes to treating a stroke. Don't wait to see if the signs and symptoms go away. Call 911. Treatment can be more effective if given quickly.

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