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New Stroke Guidelines Stress Treatment Within One Hour of Arrival in ER
Date:2/1/2013

By Steven Reinberg
HealthDay Reporter

THURSDAY, Jan. 31 (HealthDay News) -- New guidelines on stroke care stress that getting clot-busting drugs and other treatments within one hour of arriving in the emergency room is crucial to minimizing brain damage and speeding recovery.

"We have incorporated a lot of learning and experience in the past five years in developing stroke systems of care," said guideline author Dr. Edward Jauch, director of the division of emergency medicine at the Medical University of South Carolina, in Charleston.

"It's not just a single person managing a stroke that makes a difference. It's creating a process that involves patients, people around patients, pre-hospital care and hospitals," he said. "When all these pieces are in place, the patient has the best chance for having a good outcome."

The new guidelines, from the American Stroke Association, were published online Jan. 31 and will appear in the March print issue of the journal Stroke.

The most common type of stroke, called an ischemic stroke, is caused by a blood clot in an artery in the brain. Ischemic strokes account for 90 percent of all strokes.

Once doctors determine that a patient is suffering a stroke, treatment usually begins with a brain scan to find the clot. A drug called tissue plasminogen activator (tPA) is then injected to break up the clot. To be most effective, tPA needs to be given within four and a half hours of the first appearance of symptoms, the experts said.

To get treatment within this narrow window of time, the new guidelines stress calling 911 and getting to the hospital by ambulance. Not only is an ambulance faster, but it also allows emergency-room doctors to prepare for the patient's arrival.

"If you arrive at a hospital by [ambulance], you get treated very differently than if you arrive in our lobby," Jauch said. Patients see a doctor faster, get a CT scan faster and get
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