Mississippi Rolls Out Stroke Network

Feb. 05--A statewide collaborative network is giving strokes the heart attack treatment.

The Mississippi Stroke Network system of care is up and running. Similar to the STEMI (heart attack) and trauma systems, the goal is to quickly identify and treat strokes, minimizing the damage to the brain.

"It provides a structure to make sure patients are treated in a timely manner," said Tupelo neurologist Dr. Sam Newell.

Strokes, which are the fifth-leading cause of death in Mississippi, occur when blood flow is cut off to part of the brain; they can be caused by a clot or by bleeding.

The strokes caused by clots can be treated with a clot-busting drug -- tPA. It must be given within three hours of the onset of symptoms, and doctors have to rule out a bleeding stroke or other possible conditions, like brain tumors, before it's administered, Newell said.

Neurologists from around the state, the Mississippi Healthcare Alliance, the Mississippi State Department of Health, the Mississippi Hospital Association and the American Heart Association all worked together to develop protocols for first responders, hospitals and doctors. Mississippi is the first state to have three networks in place.

"It's a great collaboration," said Jim Craig, director of health protection for the Mississippi State Health Department. "It's about getting the right patients to the right facility in the right amount of time."

How it works

The first link in the chain is getting people to recognize a stroke and act quickly, Newell said. If someone has a sudden attack of dizziness, numbness, especially on one side, trouble talking or understanding, they don't need to wait more than five minutes for symptoms to resolve. Call 911.

"You need to take it seriously," Newell said.

Under the protocols, emergency medical crews are using assessment scales to check for suspected stroke patients and heading for the closest hospital that can identify and start treatment.

Mississippi hospitals can designate themselves as one of three stroke-ready levels based on the care they can provide.

Most hospitals are designated as Level 3 stroke hospitals. They have CT scanner and the clot-busting drugs available. Based on an examination and the results of the CT scan, emergency physicians can start the clot-busting drugs and send the patient on to a higher level of care.

Level II stroke hospitals, including North Mississippi Medical Center in Tupelo, Baptist Hospital in Jackson, Anderson Medical Center in Meridian, Singing River Hospital in Pascagoula and Gulfport Memorial Hospital, have neurologists available 24/7, along with the CT scanner and clot-busting drugs.

Level 1 hospitals -- currently University of Mississippi Medical Center and St. Dominic Hospital, both in Jackson, have additional interventional neurologists available, which can perform a procedure to remove a clot.

Success

Health advocates are hopeful they can see the same gains for strokes as they've seen for heart attacks. When Mississippi began its STEMI (heart attack) network in 2011, Mississippians had the highest death rate for heart attacks in the country, said Tupelo cardiologist Dr. Barry Bertolet. The STEMI network protocols focused on giving emergency responders equipment to identify ST-elevated heart attacks en route to the hospital, getting patients directly to hospitals where cardiologists were available to open blocked arteries and place stents and streamlining the process of treatment when they got to the hospital.

Based on preliminary data, the STEMI network has made a huge difference.

"We have a lower death rate than the national average with sicker patients," Bertolet said. "We're the first to demonstrate that an organized network of care saves lives."

michaela.morris@journalinc.com

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MAKE IT FAST

This simple test was developed through the American Stroke Association. Anyone can administer this test to look for sudden changes that may indicate a stroke.

--F -- Face drooping or numb. Smile and see if there's a difference on one side.

--A -- Arms drooping or numb. Hold arms out parallel to the floor. Is one side noticeably weaker?

--S -- Speech difficulties. Trouble talking or understanding.

--T -- Time to call 911. Potential stroke victims need to get to a stroke-ready hospital.

Copyright 2015 - Northeast Mississippi Daily Journal, Tupelo