Ask the Nurse: Stroke Awareness 

Sharon Ellrich shares stroke advice
at the Senior Expo in May

Stroke is always on Sharon Ellrich's mind. In her role as stroke program coordinator at Mary Greeley Medical Center, Ellrich ensures patients experiencing stroke receive care that is considered best practice for the disease. A nurse at Mary Greeley for 27 years, Ellrich, R.N., M.S.N., provides stroke care and stroke awareness education for hospital staff, emergency medical workers and the public. She also stays busy making sure the medical center continues to meet all the standards for stroke care established by the Brain Attack Coalition. Here, she provides information about stroke that everyone should know.

Q: What is stroke?

A: Strokes happen when a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot (ischemic stroke) or ruptures (hemorrhagic stroke). When this happens, part of the brain is deprived of blood and oxygen, destroying millions of valuable nerve cells within minutes. A transient ischemic attack (TIA) is a brief period of symptoms similar to those experienced in a stroke.

Q: What are the symptoms of stroke?

A: The primary stroke symptoms include:

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

Q: Why is stroke a big deal?

A: According to the American Heart Association, stroke is the fourth leading cause of death and a leading cause of adult disability in the United States. On average, every 40 seconds someone in the United States has a stroke, and roughly every four minutes someone dies from a stroke.

Q: What are the risk factors?

A: Smoking doubles one's risk of stroke. Other risk factors include:

• Diabetes
• Hyperlipidemia (high blood cholesterol levels)
• Hypertension (high blood pressure)
• Obesity
• Heart disease
• Previous stroke or TIA
• Passive smoking (secondhand smoke)

Q: What can I do to help someone who is having a stroke?

A: It’s important to learn stroke warning signs and how to respond to them. Use the FAST acronym as a test to remember warning signs:
Face: Ask the person to smile. Does one side of the face droop?
Arms: Ask the person to raise both arms. Does one arm drift
downward?
Speech: Ask the person to repeat a simple sentence. Are the words
slurred? Can the person repeat the sentence correctly?
Time: If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.

Q: Why is time so important in treating stroke?

A: The earlier a stroke is recognized and the patient receives medical attention, the greater the patient’s chance of recovery. Once stroke is diagnosed, medical professionals can administer Alteplase, a drug that helps the body dissolve the clot and save brain cells. To be most effective, Alteplase must be given within three hours from when the symptoms began. In the last six months, only 16 percent of patients with strokes arrived at a hospital in time to be considered for treatment. By recognizing stroke symptoms and calling 911 immediately, you may be able to save a life.

Q: What does Mary Greeley Medical Center offer for stroke care?

A: Mary Greeley was certified as a Primary Stroke Center in March 2012 by DNV, an independent, not-for-profit organization. (See "Mary Greeley Medical Center Named a Primary Stroke Center" below.) We offer services to our clients through the full spectrum of stroke care: emergency, intensive, acute and inpatient rehabilitation. Plus, we have physical therapy, occupational therapy and speech pathology at all levels of inpatient care as well as when the patient is discharged. Social work case managers help transition patients to the most appropriate level of care. We have five board certified neurologists and a neurosurgeon on staff. We also have an active stroke support group, which provides support for both stroke survivors and caregivers.

Q: Former Iowa State University football coach Dan McCarney had a stroke early this year that generated a lot of attention on stroke awareness. What lessons can we take from his situation?

A: McCarney suffered numbness on the left side of his body and called 911. He was treated quickly and is doing well. In a statement he released a few days after his stroke, he credited the minimal impact of the stroke to early recognition of the symptoms and the quick response of paramedics. His statement offered great advice for all of us: "If there is any lesson to be learned in all of this it is to make yourself aware of the signs of a stroke and act immediately when those signs become present. I’m not sure if our quick reaction saved my life, but it definitely saved the quality of my life."

Mary Greeley Medical Center Named a Primary Stroke Center

Mary Greeley Medical Center has received Primary Stroke Center Certification from DNV Healthcare.

The certification recognizes that Mary Greeley Medical Center is committed to meeting all the standards for quality stroke care. It also signifies to paramedics in central Iowa that stroke victims can be transported to Mary Greeley for emergency treatment. Immediate treatment is vital to stroke survival and minimal long-term disabilities.

The certification is the result of a review process that verifies the quality and comprehensiveness of stroke services in a variety of areas, including equipment, emergency procedures and neurological care. Neurological care is provided by five board certified neurologists with McFarland Clinic. Examiners with DNV visited Mary Greeley and followed the path of a stroke patient, from admission, intensive care, inpatient, physical therapy and discharge.

DNV is a recognized by The Centers for Medicare and Medicaid Services as an accreditation agency for U.S. hospitals. DNV's Primary Stroke Center Certification program incorporates requirements from the Guidelines of the Brain Attack Coalition and recommendations of the American Stroke Association.