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Hospital offers improved treatment for stroke victims A patient came to Grove Hill Memorial Hospital at 6:30 one morning a month ago, complaining of a weakness on the left side, said Doug Sewell, hospital administrator. "His wife brought him to the hospital." A CT (Computed tomography) scan was performed; the hospital staff consulted with a neurologist, and the drug TPA (tissue plasminogen activator) was given to the patient for dissolving a blood clot. The patient was then sent to the University of South Alabama Hospital. "By that afternoon, his stroke had totally resolved," Sewell said. He had regained use of his left side and his speech. "Two weeks later, the neurologist in Mobile said instead of going to a nursing home, the 57- year-old man is going back to work." The result of early action was a success story for a new treatment for stroke victims at the Grove Hill facility. "Early intervention is the key," the administrator said. If people can come to a hospital that has a dedicated treatment, within the first three hours of having symptoms, there is a possibility of a positive outcome. There has been a treatment for heart attacks for many years, he said. "The vast majority of heart attacks are caused by a blood clot, closing off an artery that feeds the oxygen to the heart. "Years ago, they came up with clot busting drugs (such as) TPA. If you inject it within a certain time frame, you can dissolve the clot and open up the circulation back to the heart, which minimizes damage….It has saved millions of lives." Several years ago, doctors began experimenting with TPA on clots that cut off arteries to the brain and causing strokes. "A high percentage of all strokes are caused by clots cutting off circulation to the brain," Sewell said. The Grove Hill hospital had been working for over a year with the Mobile Infirmary and the University of South Alabama Hospital to establish a stroke treatment program. The local hospital acquired a PAC (Picture Archiving Communication System) two years ago in which X-rays (which used to be on film) are now images on a computer. "We've had our X-rays read as far away as Australia," Sewell said. "Our radiologist here, Dr. Himath Singh, he went to India several times. If he took his laptop with him, he could pull up the films there in India and read them. ...It opened up a whole new game for us. We were able to do these X-rays." Symptoms of a stroke include dizziness, blurred vision, a speech impairment, and tingling or numbness in the limbs, he said. There are also TIA's (transient ischemic attacks), where there will be numbness or tingling on one side and it comes and goes. "That means that the blood supply is opening up and then it closes up….They will have these for three or four days before they actually have their stroke." If there are any of these symptoms are prevalent, a person should call their doctor or come to the Emergency Room. When a patient comes in and you suspect a stroke, the first thing done is get a CT scan, Sewell said. "You have to have the radiologist read that CT scan. Because of the clock ticking, you have to be able to do it in a very short period of time. In regards to their success with the 57-year-old patient, "with our connection to a radiology group in Birmingham, we were able to do the CT scan, send the images to Birmingham, have them read by a board-certified radiologist and give the report back in less than an hour. In turn, our ER doctor talked to one of the neurologists at South Alabama and told him the finds of the CT scan," he said. "They gave us directions on how much of the drug to give. …We continue to work developing protocols. I'm not sure many rural facilities are doing this….There's no reason rural hospitals cannot do this. "Before we did this treatment, the patient would have come to our hospital. We couldn't administer the meds. We didn't have the capability of sending the X-rays right away." The patient would have been evaluated and transferred to another hospital in Mobile "and the golden three hours would long since be gone," Sewell said. "You just couldn't do it in a timely manner, and the patient would suffer from it."
New technology continues to aid rural hospitals in administering life saving treatments more on par with urban hospitals, he said.
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